A small tank, to be filled every six months and that’s it. A nice advantage over the annoying monthly injections that engage patients, their carers and clog up the ophthalmology departments today. Yes, because age-related macular degeneration, a form of maculopathy, is the leading cause of blindness in the Western world. And treating it – with periodic eye injections – is a commitment for everyone, both for patients, generally the elderly, and for clinicians. This is why the news of the first Italian patient who was operated on yesterday to implant a reservoir for slow drug release in his eye is so innovative: it could change the management of the disease.
Age-related macular degeneration
To tell all this is Stanislao Rizzo, professor of ophthalmology at the Catholic University of the Sacred Heart and director of the Uoc of ophthalmology of the Agostino Gemelli IRCCS University Hospital in Rome. Here yesterday, Rizzo together with colleagues Angelo Maria Minnella and Tomaso Caporossi, performed the surgery to implant a small Port Delivery System (PDS), essentially a small reservoir, in a patient with wet age-related macular degeneration. “We distinguish two forms of disease, in fact, a dry one with slow progression, essentially due to tissue atrophy and for which there are no treatments yet except in the study phase, the other humid, in which the formation of new blood vessels under the macula, associated with the release of liquids “, explains Rizzo:” For these forms, if taken in time and if treated consistently, the treatments work and in most cases it is possible to avoid vision loss “.
The treatment is based on the administration of substances capable of blocking the growth of blood vessels, inhibiting a factor that promotes their formation. They are the anti-VEGF, or drugs that target the vascular endothelial growth factor: “There are many anti-VEGF drugs and they basically differ in treatment intervals, the latter aiming to make an injection every two months after a phase of initial treatment ”, adds Rizzo.
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A “refill” of the drug every six months
Injections into the eye of anti-VEGF drugs are quite challenging but at the same time very useful for patients. A system that would allow them to be reduced would benefit everyone. And it is in this direction that the development of the Port Delivery System (PDS) is going, containing ranibizumab, an anti-VEGF, implanted yesterday in Rome: “It is a small tank filled with the drug, which is released slowly – explains the expert. – it was developed to be refilled about once every six months “.
The operation is complex, admits Rizzo, not without potential risks (such as moving the implant) and reserved only for patients who have responded positively to the drug in the past. But although it is not yet an established practice, we are talking about a highly innovative, safe device that has already shown to work like monthly injections, resumes the expert: “We have reached phase III of the clinical trial, the final one, which if efficacy and safety are confirmed, it is a prelude to the arrival of the device on the market “. The hope is that after the trial – which involves different centers around the world, and involves the testing of two different refill intervals of the device, at 24 and 36 months – in the future it can be offered to patients, changing the history of their treatments against the macular degeneration.
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