新型双特异性单抗Faricimab治疗糖尿病性黄斑水肿及年龄相关性黄斑变性的研究进展

Research progress of novel bispecific monoclonal antibody Faricimab in the treatment of diabetic macular edema and age-related macular degeneration

糖尿病性黄斑水肿(DME)和年龄相关性黄斑变性(ARMD)是世界范围内视力损害和失明的主要原因,二者共同的病理特征是血管通透性增加和异常新生血管,血管内皮生长因子(VEGF)及血管生成素-2(Ang-2)等细胞因子在其中起着重要作用。抗VEGF制剂玻璃体内注射显著改变了DME和ARMD的临床管理,但无反应病例的存在、频繁注射带来的治疗负担及风险等局限性需要克服。Faricimab是一种同时靶向阻断VEGF-A和Ang-2的新型双特异性单抗,可有效降低血管通透性、减少新生血管数量和减轻视网膜水肿。注册临床研究显示Faricimab可有效改善视力和消退视网膜积液,相较于阿柏西普和雷珠单抗具有非劣效性,能维持较长的给药间隔,同时具有较高的安全性。本文就Faricimab在DME和ARMD治疗中的最新进展做一综述。

Diabetic macular edema(DME)and age-related macular degeneration(ARMD)are the leading causes of visual impairment and blindness worldwide,and their common pathological features are increased vascular permeability and abnormal neovascularization,in which cytokines such as vascular endothelial growth factor(VEGF)and angiopoietin-2(Ang-2)play an important role.Intravitreal injection of anti-VEGF agents significantly changed the clinical management of DME and ARMD,but limitations such as the non-responsive cases,the treatment burden and risks caused by frequent injections need to be overcome.Faricimab,a novel bispecific monoclonal antibody that simultaneously targets VEGF-A and Ang-2,can effectively reduce vascular permeability,decrease the number of neovascularization and alleviate retinal edema.Registered clinical studies have shown that Faricimab is effective in improving vision and reducing retinal edema,which is non-inferior to Aflibercept and Ranibizumab,maintains a long dosing interval,and has a high safety profile.This article reviews the latest advances in the treatment of DME and ARMD with Faricimab.