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The therapeutic landscape for AMD will see new medications emerge in the coming years as new advancements take place in the pharmaceutical sector.
Fremont, CA: Intravitreal injections, made possible by technological advancements, have revolutionized the treatment of numerous retinal diseases and are now the most frequently done ophthalmic procedure. VEGF antagonists have shown to be effective in several studies, yet there are situations when the real-world application of these treatments falls short of those in prior published randomized clinical trials. Poor patient compliance and under-treatment may play a role in this. Patients' compliance with treatment and treatment rates are both improved when drugs have a longer life.
New retinal developments in 2022
Biosimilars
Given that the patents for ranibizumab and aflibercept are about to expire in the United States, efforts to develop biosimilar drugs as an alternate treatment to reduce the expensive burden of injections are being made. In contrast to generic drugs, biosimilars try to duplicate the therapeutic effect of existing medications rather than their molecular structure.
Interestingly, when a biosimilar is approved for a single indication, automatic approval for all indications of the reference medication is obtained. For example, SB-11 is the United States' first ophthalmology biosimilar. It fulfilled the primary aim of non-inferiority to monthly ranibizumab with comparative safety in phase III randomized controlled clinical study in the treatment of neovascular AMD at 4 and 8 weeks.
Pipeline AMD targets
Bioengineering advances have led to the development of ankyrin repeat proteins (DARPins), which are engineered to have a high degree of selectivity and affinity for a specific target. Unlike antibodies, which comprise classic VEGF antagonists, these medicines are smaller and may exhibit increased tissue penetration and binding affinity. This stability may allow them to be effective at lower concentrations and have a longer-lasting effect. Abiciparpegol, like ranibizumab, is a DARPin that is designed to bind to all VEGF-A isoforms.
It has a stronger affinity and a longer intraocular half-life than ranibizumab, according to studies. The REACH study, a phase II multicenter randomized controlled trial for patients with neovascular AMD, demonstrated that improvements in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were comparable in both abicipar and ranibizumab groups and were maintained for three months following the third injection.
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