新型小分子抗VEGF药物Brolucizumab治疗糖尿病性黄斑水肿的研究进展

Research progress of novel small molecule anti-VEGF drug Brolucizumab in the treatment of diabetic macular edema

糖尿病性黄斑水肿(DME)是糖尿病患者视力损害的主要原因,目前抗血管内皮生长因子(VEGF)药物玻璃体腔注射已成为DME首选治疗,但频繁注射带来的经济负担及相关并发症不容忽视,因此开发疗效更持久的药物以延迟注射间隔十分必要。Brolucizumab是一种对VEGF具有高亲和力的单链抗体片段(scFv),与其它抗VEGF药物相比,其具有分子量小、组织穿透性强和作用更持久的特点。临床研究及真实世界证据表明Brolucizumab在提高DME患者视力方面非劣效于阿柏西普,且其消退视网膜积液及降低黄斑中心凹厚度(CSFT)作用更强,注射间隔更长。同时,Brolucizumab眼内注射后不良事件发生率低,具有良好的安全性。本文就Brolucizumab在治疗DME中的最新进展做一综述。

Diabetic macular edema(DME) has become the leading cause of vision loss in patients with diabetes. Currently, intravitreal injection of anti-vascular endothelial growth factor(VEGF) therapy is the first-line treatment for DME. However, the economic burden and related complications brought by frequent injections should not be ignored. Therefore, the drugs with longer-lasting effects and longer injection intervals must be explored. Brolucizumab is a single-chain antibody fragment(scFv) with a high affinity for VEGF. Compared with other available anti-VEGFs, it has the characteristics of smaller molecular weight, higher tissue permeability and durable therapeutic effect. Clinical studies and real-world evidences showed that Brolucizumab is non-inferior to aflibercept in improving visual acuity in patients with DME. And Brolucizumab is more effective in regressing intra-retinal fluid and reducing central foveal thickness(CSFT) with longer injection interval. At the same time, Brolucizumab has a low incidence of adverse events and favourable safety after intraocular injection. This article reviews the latest progress of Brolucizumab in the treatment of DME.