Mohammad Ali Sadiq1, Muhammad Sohail Halim2,3, Muhammad Hassan2, Neil Onghanseng2, Irmak Karaca4, Aniruddha Agarwal5, Rubbia Afridi2,3, Yasir J Sepah2, Diana V Do2, Quan Dong Nguyen2. 1. Department of Ophthalmology, University of Louisville, Louisville, KY USA. 2. Byers Eye Institute, Stanford University, Palo Alto, CA 94303 USA. 3. Ocular Imaging Research and Reading Center (OIRRC), Sunnyvale, CA USA. 4. Department of Ophthalmology, Ege University School of Medicine, Izmir, Turkey. 5. Advanced Eye Centre, Department of Ophthalmology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Abstract
BACKGROUND: Diabetic macular edema (DME) is the leading cause of visual loss in patients with diabetic retinopathy. There has been a paradigm shift in the treatment of DME since the advent of anti-vascular endothelial growth factor (anti-VEGF) therapy. The safety and efficacy of anti-VEGF therapy has been well established. Although efficacious, currently approved anti-VEGF agents are associated with certain limitations, which include, among others: frequent need for injections, high treatment cost and variable response to treatment. These challenges have led to an active search for more novel agents that may be able to overcome these limitations. AREAS COVERED: The index review focuses on novel treatment agents that target various pathways in patients with DME. These agents are used either as monotherapy or in combination with other agents in the management of DME. Drugs discussed include novel anti-VEGF inhibitors, TIE-2 receptor modulators, integrin peptide inhibitors, rho kinase inhibitors, and future therapies such as neuroprotection and gene therapy. CONCLUSIONS: The future of investigational pharmacological therapy appears promising for patients with DME. Results from early clinical trials indicate that newer agents highlighted in the study may be safe and efficacious treatment options for patients with DME. However, data from large multicenter clinical trials need to be analyzed before these agents can be incorporated into clinical practice.
BACKGROUND: Diabetic macular edema (DME) is the leading cause of visual loss in patients with diabetic retinopathy. There has been a paradigm shift in the treatment of DME since the advent of anti-vascular endothelial growth factor (anti-VEGF) therapy. The safety and efficacy of anti-VEGF therapy has been well established. Although efficacious, currently approved anti-VEGF agents are associated with certain limitations, which include, among others: frequent need for injections, high treatment cost and variable response to treatment. These challenges have led to an active search for more novel agents that may be able to overcome these limitations. AREAS COVERED: The index review focuses on novel treatment agents that target various pathways in patients with DME. These agents are used either as monotherapy or in combination with other agents in the management of DME. Drugs discussed include novel anti-VEGF inhibitors, TIE-2 receptor modulators, integrin peptide inhibitors, rho kinase inhibitors, and future therapies such as neuroprotection and gene therapy. CONCLUSIONS: The future of investigational pharmacological therapy appears promising for patients with DME. Results from early clinical trials indicate that newer agents highlighted in the study may be safe and efficacious treatment options for patients with DME. However, data from large multicenter clinical trials need to be analyzed before these agents can be incorporated into clinical practice.
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Authors: Mohammad Ali Sadiq; Muhammad Sohail Halim; Muha Mmad Hassan; Neil Onghanseng; Irmak Karaca; Aniruddha Agarwal; Rubbia Afridi; Yasir J Sepah; Diana V Do; Quan Dong Nguyen Journal: Int J Retina Vitreous Date: 2020-12-07