Age-related macular degeneration is the leading cause of blindness in the Western world. For wet (or neovascular) forms, treatment involves injecting drugs into the eye that aim to block the growth of the blood vessels underlying the disease. Today, however, the challenge is to find solutions that allow patients to extend the time between injections, simplifying therapy. Therefore, fewer administrations, but with the same effectiveness, so as to improve patient management. And the results coming from the TENAYA and LUCERNE studies, presented at the American Society of Retina Specialists congress in 2022, go precisely in this direction, demonstrating that it is possible to do fewer injections without losing effectiveness in the treatment.
Macular degeneration: beware of the signs (and how to detect them)
by Tiziana Moriconi
A new dual-target drug
The studies in question concern the drug faricimab, an innovative bispecific antibody, that is, which targets two different targets. In addition to inhibiting vascular endothelial growth factor A (VEGF-A), like many other treatments for wet age-related macular degeneration, faricimab also targets angiopoietin 2 (Ang-2) to stabilize blood vessels (Ang-2 is believed to contribute to vascular destabilization and thus to loss of vision in the disease). In the TENAYA and LUCERNE studies, patients received faricimab at different intervals (two, three, or four months) or aflibercept (another anti-VEGF) every two months, and in the second year the dose for patients treated with faricimab could be adjusted. based on their answers. At two years, the improvements in vision were comparable across the treatment arms, but over 60% of patients treated with bispecific antibody were treated every 4 months, and 80% at intervals of at least three months.
Two new strategies against two eye diseases
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The benefits of reducing injections
Overall, therefore, faricimab patients received fewer injections than those treated with aflibercept. With a potential advantage in terms of adherence to therapy, commented Giovanni Staurenghi, Professor of Visual Diseases of the State University of Milan, Sacco Hospital: “Therapies aimed at inhibiting the growth of new blood vessels are effective but complex to manage, especially for the patient who has to undergo frequent and continuous intravitreal injections. Adherence to therapy is as essential as timely diagnosis, in order to delay the progression of the disease. Treatments such as faricimab, which allow to lengthen the time interval between one administration and the next, could represent an important support for the patient in having a full therapeutic adherence. These data represent an important step forward for patients and for the entire scientific community “. The drug, already approved in the US and other countries for age-related macular degeneration and diabetic macular edema, is currently being evaluated by the European Medicines Agency.
Age-related macular degeneration, the US approves the first bispecific antibody
by Tiziana Moriconi
