Curative Biotechnology Inc (CUBT)

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Age-Related Macular Degeneration: Modern Retina

Prof. Goes: The longer lifespan of mankind is accom­panied by age-related diseases such as cataract and age-related macular degeneration (AMD). Unfortunately, for around 20 years, treatment has been available only for the less-common form, wet AMD.

For the most common form of macular degeneration, dry AMD, which represents about 80% of diagnosed cases, there is no efficient treatment yet.

Estimations are that, in the USA alone, 11 million peo­ple have dry AMD, while 1.5 million (~15% of all AMD) are affected by the advanced stages of the disease.2,3

It would be a major challenge to find a way to pre­vent or eventually cure this disease. Millions of people would benefit from such a realisation.

Prof. Augustin: Wet and dry AMD (wAMD, dAMD) is still a major sight-threatening disease. Healing of the disease is still not possible.

Anti-VEGF drugs seem to be a breakthrough. Howev­er, a portion of our patients do not respond adequately and their retinal pigment epithelium is altered as a result of the continous treatment

In the next year we are expecting the first medi­cal treatments for dAMD and several biosimilars for wAMD. We will have to use our complete armamen­tarium (artificial intelligence in combination with multimodal imaging) to critically evaluate these new approaches/drugs.

Dr de Silva: A welcome challenge for retinal spe­cialists in 2023 is the advent of new, and in some cases longer acting, anti-VEGF agents for the treatment of retinal disease.

We have seen through 2022 the licensing and ap­proval of faricimab (Roche), an intravitreal agent that inhibits both anti-VEGF and Ang-2, with clinical trial data reporting a maintenance dosing interval of 16 weeks in approximately 45% of patients with AMD at week 48 after starting treatment.4

We now therefore have four licensed anti-VEGF medications (ranibizumab [Novartis], aflibercept [Regeneron], brolucizumab [Novartis] and faricimab), with ranibizumab biosimilars also available, for both neovascular AMD and diabetic macular oedema.

It is now in the hands of retinal specialists to weigh up the relative benefits and cost-effectiveness of these different medications for their patient populations and to implement optimal protocols.

Further real-world data emerging through 2023 will aid and clarify these decisions, and clinical trials are also ongoing for gene therapy approaches to treat neo­vascular AMD, which may lead to even longer acting therapies in the coming years.

https://www.modernretina.com/view/2023-what-awaits-ophthalmology-in-the-year-ahead