湿性年龄相关性黄斑变性的新药研发进展

The development of new drugs for wet age-related macular degeneration

年龄相关性黄斑变性(age-related macular degeneration,AMD)是西方国家65岁以上人群不可逆致盲的首要因素。AMD主要分2种类型,干性(dryAMD)和湿性(wet AMD,wAMD)。湿性年龄相关性黄斑变性(wAMD)的主要病理基础是脉络膜新生血管化(CNV),而血管内皮生长因子(VEGF)已被证实在CNV中起重要作用。抗VEGF玻璃体腔注射是目前治疗wAMD的首选药物。应用最广泛的抗VEGF药物包括贝伐单抗、雷珠单抗和阿柏西普。尽管如此,抗VEGF治疗仍存在一些弊端,包括价格昂贵、需反复多次玻璃体内注射、无效及难治性病例也并不少见。许多新药正在被开发用来解决现有抗VEGF疗法的弊端。通过检索国内外相关文献及报道,我们对处于临床阶段的wAMD新药的临床研究进展进行了综述。

Age-related macular degeneration(AMD)is the leading cause of irreversible legal blindness in people≥65 years of age in the Western world.AMD is classified into 2 general subgroups:dry form and wet form of the disease.The main pathology of wet AMD is choroidal neovascularization(CNV),in which vascular endothelial growth factor(VEGF)has been proven to play a major part.Intravitreal injection of anti-VEGF antibody is considered the mainstay for wet AMD(wAMD).The most widely utilized anti-VEGF medications include bevacizumab,ranibizumab,and aflibercept.Nonetheless,there are still several shortcomings in anti-VEGF treatment,including its high cost,requirement for frequent intravitreal injections,incomplete response,and/or failure to maintain response in some patients.Many new drugs are currently being developed to address the shortcomings of anti-VEGF treatment.By searching the related literature and reports,the development of new drugs was summarized for wAMD at clinical stage.