Preview

Российский офтальмологический журнал

Расширенный поиск

Подходы к назначению антиангиогенных препаратов при терапии пациентов с неоваскулярной возрастной макулярной дегенерацией

https://doi.org/10.21516/2072-0076-2019-12-3-102-112

Полный текст:

Аннотация

Возрастная макулярная дегенерация (ВМД) — хроническое прогрессирующее заболевание, являющееся основной причиной инвалидности по зрению среди пациентов старшей возрастной группы в индустриально развитых странах. При этом наибольшим риском потери зрения характеризуется неоваскулярная ВМД. Стандартом терапии этого заболевания в настоящее время признано интравитреальное введение ингибиторов ангиогенеза. Показано, что применение ингибиторов ангиогенеза позволяет добиться стабилизации зрительных функций в более чем 90 % случаев и улучшения зрения на 3 строки и более (15 букв по шкале ETDRS) у 30–40 % пациентов. Тем не менее результаты наблюдательных исследований свидетельствуют о существовании барьеров, препятствующих эффективному проведению антиангиогенной терапии в условиях рутинной клинической практики. Одним из возможных путей преодоления данных барьеров является поиск оптимального режима назначения ингибиторов ангиогенеза, позволяющего уменьшить число необходимых инъекций без потери терапевтической эффективности. В обзоре рассмотрена текущая доказательная база, посвященная принципам назначения антиVEGF препаратов при лечении пациентов с неоваскулярной ВМД, проанализированы используемые в практике режимы дозирования с учетом их преимуществ и недостатков.

Об авторах

И. Э. Иошин
ФГБУ «Клиническая больница» Управления делами Президента Российской Федерации
Россия

д-р мед. наук, профессор, заведующий отдедением

107143, Москва, ул. Лосиноостровская, д. 45



Т. А. Аноприева
АО «БАЙЕР»
Россия

медицинский советник

107113, Москва, 3-я Рыбинская ул., д. 18, стр. 2



Список литературы

1. Аветисов С.Е., Егоров Е.А., Мошетова Л.К., Нероев В.В., Тахчиди Х.П., ред. Офтальмология: национальное руководство. 2-е изд. Москва: ГЕОТАР-Медиа; 2018.

2. Wykoff C.C., Clark W.L., Nielsen J.S., et al. Optimizing anti-VEGF treatment outcomes for patients with neovascular age-related macular degeneration. J. Manag. Care Spec. Pharm. 2018 Feb; 24(2-a Suppl): S3-S15. doi: 10.18553/jmcp.2018.24.2-a.s3

3. Wong W.L., Su X., Li X., et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob. Health. 2014 Feb; 2 (2):e106-16. doi: 10.1016/S2214-109X(13)70145-1

4. Ferrara N. Vascular endothelial growth factor and age-related macular degeneration: from basic science to therapy. Nat. Med. 2010 Oct; 16( 10): 1107–11. doi: 10.1038/nm1010-1107

5. Ferrara N., Gerber H.P., Le Couter J. The biology of VEGF and its receptors. Nat Med. 2003 Jun; 9 (6): 669–76. doi: 10.1038/ nm0603-669

6. American Academy of Ophthalmology. Retina/Vitreous Panel. Preferred Practice Pattern Guidelines. Age-related Macular Degeneration. San Francisco, CA: American Academy of Ophthalmology. Updated 2015. Available at: https://www.aao.org/ preferred-practice-pattern/age-related-macular-degenerationppp-2015

7. Schmidt-Erfurth U., Chong V., Loewenstein A., et al. Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA). Br. J. Ophthalmol. 2014 Sep; 98 (9): 1144–67. doi: 10.1136/ bjophthalmol-2014-305702

8. Возрастная макулярная дегенерация. Клинические рекомендации; 2017. Доступно на http://avo-portal.ru/doc/fkr/ approved/item/261-vozrastnaya-makulyarnaya-degeneratsiya

9. Papadopoulos N., Martin J., Ruan Q., et al. Binding and neutralization of vascular endothelial growth factor (VEGF) and related ligands by VEGF Trap, ranibizumab and bevacizumab. Angiogenesis. 2012 Jun;15 (2): 171–85. doi: 10.1007/s10456-0119249-6

10. Иошин И.Э. Безопасность интравитреальных инъекций. Офтальмохирургия. 2017; 3: 71–9.

11. Holash J., Davis S., Papadopoulos N., et al. VEGF-Trap: a VEGF blocker with potent antitumor effects. In: Proc. of the National Academy of Sciences of the USA. 2002; 99 (17): 11393–8. https:// doi.org/10.1073/pnas.172398299

12. Brown D.M., Kaiser P.K., Michels M., et al. Ranibizumab versus Verteporfin for neovascular age-related macular degeneration. New England Journal of Medicine. 2006; 355: 1432–44. https:// doi.org/10.1056/nejmoa062655

13. Rosenfeld P.J., Brown D.M., Jeffrey S.H., et al. Ranibizumab for neovascular age-related macular degeneration. New England Journal of Medicine. 2006; 355: 1419–31. https://doi.org/10.1056/ nejmoa054481

14. Heier J.S., Brown D.M., Chong V., et al. Intravitreal Aflibercept (VEGF Trap-Eye) in wet age-related macular degeneration. Ophthalmology. 2012; 119: 2537–48. https://doi.org/10.1016/j. ophtha.2012.09.006

15. Framme C., Eter N., Hamacher T., et al. Aflibercept for patients with neovascular age-related macular degeneration in routine clinical practice in Germany: twelve-month outcomes of PERSEUS. Ophthalmology Retina. 2018; 2: 539–49. https://doi.org/10.1016/j. oret.2017.09.017

16. Eleftheriadou M., Vazquez-Alfageme C., Citu C.M., et al. Long-term outcomes of Aflibercept treatment for neovascular age-related macular degeneration in a clinical setting. American Journal of Ophthalmology. 2017; 174: 160–8. https://doi.org/10.1016/j. ajo.2016.09.038

17. Epstein D., Amren U. Near vision outcome in patients with age-related macular degeneration treated with aflibercept. Retina. 2016; 36 (9): 1773–7. https://doi.org/10.1097/ iae.0000000000000978

18. Talks J.S., Lotery A.J., Ghanchi F., et al. First-year visual acuity outcomes in the United Kingdom of providing aflibercept according to the VIEW study protocol for age-related macular degeneration. Ophthalmology. 2016 Feb; 123 (2): 337–43. doi: 10.1016/j. ophtha.2015.09.039

19. Almuhtaseb H., Kanavati S., Rufai S.R., Lotery A.J. One-year realworld outcomes in patients receiving fixed dosing aflibercept for neovascular age-related macular degeneration. Eye (Lond). Eye (Lond). 2017 Jun; 31 (6): 878–83. doi: 10.1038/eye.2017.6

20. Regillo C.D., Brown D.M., Abraham P., et al. Randomized, doublemasked, sham-controlled trial of Ranibizumab for neovascular age-related macular degeneration. Am. J. Ophthalmol. 2008; 145: 239–48. https://doi.org/10.1016/j.ajo.2007.10.004

21. Schmidt-Erfurth U., Eldem B., Guymer R., et al. Efficacy and safety of monthly versus quarterly Ranibizumab treatment in neovascular age related macular degeneration. Ophthalmology. 2011; 118: 831–9. https://doi.org/10.1016/j.ophtha.2010.09.004

22. Garcia-Layana A., Figueroa M.S., Araiz J., et al. Treatment of exudative age-related macular degeneration: focus on Aflibercept. Drugs Aging. 2015; 32: 797–807. https://doi.org/10.1007/s40266-015-0300-y

23. Rezaei K.A., Stone T.W., eds. Global trends in retina survey. Chicago: American Society of Retina Specialists; 2015.

24. Fung A.E., Lalwani G.A., Rosenfeld P.J. An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am. J. Ophthalmol. 2007 Apr; 143 (4): 566–83. doi: 10.1016/j.ajo.2007.01.028

25. Holz F.G., Amoaku W., Donate J., et al. Safety and efficacy of a flexible dosing regimen of ranibizumab in neovascular age-related macular degeneration: the SUSTAIN study. Ophthalmology. 2011; 118 (4): 663–71. doi: 10.1016/j.ophtha.2010.12.019

26. Boyer D.S., Heier J.S., Brown D.M., et al. A Phase IIIb study to evaluate the safety of ranibizumab in subjects with neovascular age-related macular degeneration. Ophthalmology. 2009; 116 (9): 1731–9. doi: 10.1016/j.ophtha.2009.05.024

27. CATT Research Group. (2011). Ranibizumab and bevacizumab for neovascular age-related macular degeneration. New England Journal of Medicine. 364 (20): 1897–908.

28. Mori R., Tanaka K., Haruyama M., et al. Comparison of pro re nata versus Bimonthly Injection of Intravitreal Aflibercept for Typical Neovascular Age-Related Macular Degeneration. Ophthalmologica. 2017; 238 (1–2): 17–22.

29. Братко Г.В., Смирнов Е.В., Трунов А.Н., Черных В.В. Практика применения анти-VEGF терапии в России: результаты онлайн-опроса. Современные технологии в офтальмологии. 2015; 1: 39. Доступно на: https://eyepress.ru/article.aspx?16351

30. Holz F.G., Tadayoni R., Beatty S., et al. Multi-country real-life experience of anti-vascular endothelial growth factor therapy for wet age-related macular degeneration. Br. J. Ophthalmol. 2015; 99 (2): 220–6. doi: 10.1136/bjophthalmol-2014-305327

31. Muether P.S., Hoerster R., Hermann M.M., et al. Long-term effects of ranibizumab treatment delay in neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 2013; 251 (2): 453–8. doi: 10.1007/s00417-012-2038-0

32. Lanzetta P., Loewenstein A. Vision Academy Steering Committee. Fundamental principles of an anti-VEGF treatment regimen: optimal application of intravitreal anti-vascular endothelial growth factor therapy of macular diseases. Graefes Arch. Clin. Exp. Ophthalmol. 2017 Jul; 255 (7): 1259–73. doi: 10.1007/s00417017-3647-4

33. Mantel I., Deli A., Iglesias K., Ambresin A. Prospective study evaluating the predictability of need for retreatment with intravitreal ranibizumab for age-related macular degeneration. Graefes Arch. Clin. Exp. Ophthalmol. 2013 Mar; 251 (3): 697–704. doi: 10.1007/ s00417-012-2090-9

34. Muether P.S., Hermann M.M., Dröge K., et al. Long-term stability of vascular endothelial growth factor suppression time under ranibizumab treatment in age-related macular degeneration. Am. J. Ophthalmol. 2013 Nov; 156 (5): 989–93.e2. doi: 10.1016/j. ajo.2013.06.020

35. Fauser S., Schwabecker V., Muether P.S. Suppression of intraocular vascular endothelial growth factor during aflibercept treatment of age-related macular degeneration. Am. J. Ophthalmol. 2014 Sep; 158 (3): 532–6. doi: 10.1016/j.ajo.2014.05.025

36. Fauser S., Muether P.S. Clinical correlation to differences in ranibizumab and aflibercept vascular endothelial growth factor suppression times. Br. J .Ophthalmol. 2016 Nov; 100 (11): 1494–8. doi: 10.1136/bjophthalmol-2015-308264

37. Berg K., Pedersen T.R., Sandvik L., Bragadottir R. Comparison of ranibizumab and bevacizumab for neovascular age-related macular degeneration according to LUCAS treat-and-extend protocol. Ophthalmology. 2015; 122 (1): 146–52. doi: 10.1016/j.ophtha. 2014.07.041

38. Wykoff C.C., Croft D.E., Brown D.M., et al. Prospective trial of Treat-and- Extend versus Monthly Dosing for neovascular age-related macular degeneration: TREX-AMD 1-year results. Ophthalmology. 2015; 122 (12): 2514–22. doi: 10.1016/j. ophtha.2015.08.009

39. Silva R., Berta A., Larsen M., et al. Treat-and-extend versus monthly regimen in neovascular age-related macular degeneration: results with ranibizumab from the TREND study. Ophthalmology. 2018 Jan; 125 (1): 57–65. doi: 10.1016/j.ophtha.2017.07.014

40. Kertes P.J., Galic I.J., Greve M., et al. Canadian Treat-and-Extend analysis trial with ranibizumab in patients with neovascular age-related macular disease: one-year results of the randomized Canadian Treat-and-Extend analysis trial with ranibizumab study. Ophthalmology. 2019 Jun; 126 (6): 841–8. doi: 10.1016/j. ophtha.2019.01.013

41. Okada A.A., Takahashi K. Use of intravitreal Aflibercept Treat and-Extend dosing for wet age-related macular degeneration: 52-week ALTAIR results. In: Proc. of the American Academy of Ophthalmology (AAO) Congress; 2017 Nov 11–14; New Orleans, LA, USA. Доступно по: https://aao.scientificposters.com/ epsAbstractAAO.cfm?id=1

42. Gillies M.C., Hunyor A.P., Arnold J., et al. Effect of Ranibizumab and Aflibercept on best-corrected visual acuity in Treat-and-Extend for neovascular age-related macular degeneration: a randomized clinical trial. JAMA ophthalmology. 2019 Jan; 24: 372–9. https:// doi.org/10.1001/jamaophthalmol.2018.6776

43. Ying G.S., Huang J., Maguire M. G., et al. Baseline predictors for one-year visual outcomes with ranibizumab or bevacizumab for neovascular age-related macular degeneration. Ophthalmology. 2013 Jan; 120 (1): 122–9. doi: 10.1016/j.ophtha.2012.07.042

44. Lim J.H., Wickremasinghe S. S., Xie J., et al. Delay to treatment and visual outcomes in patients treated with anti-vascular endothelial growth factor for age-related macular degeneration. Am. J. Ophthalmol. 2012 Apr; 153 (4): 678–86, 686.e1-2. doi: 10.1016/j.ajo.2011.09.013

45. Singer M.A., Awh C.C., Sadda S., et al. HORIZON: an open-label extension trial of ranibizumab for choroidal neovascularization secondary to age-related macular degeneration. Ophthalmology. 2012 Jun; 119 (6): 1175–83. doi: 10.1016/j.ophtha.2011.12.016

46. Kaiser P.K., Singer M., Tolentino M., et al. Long-term safety and visual outcome of intravitreal aflibercept in neovascular age-related macular degeneration. VIEW 1 extension study. Ophthalmology. 2017 Aug; 128 (8): 1090–5. https://doi. org/10.1016/j.oret.2017.01.004

47. Berg K., Hadzalic E., Gjertsen I., et al. Ranibizumab or Bevacizumab for neovascular age-related macular degeneration according to the Lucentis compared to Avastin study Treat-and-Extend protocol: two-year results. Ophthalmology. 2016 Jan; 123 (1): 51–9. doi: 10.1016/j.ophtha.2015.09.018

48. Wykoff C.C., Ou W.C., Brown D.M. Randomized trial of treatand-extend versus monthly dosing for neovascular age-related macular degeneration: 2-year results of the TREX-AMD study. Ophthalmology Retina. 2017 July-August; 1 (4): 314–21. https:// doi.org/10.1016/j.oret.2016.12.004

49. Ohji M., Ayame A., Takahashi K. Two different treat-and-extend dosing regimens of intravitreal aflibercept in Japanese patients with wet age-related macular degeneration: 96-week results of the ALTAIR study. Presented at 18th EURETINA congress, VIenna, 09.2018 Доступно по: http://abstracts.euretina.org/

50. Mekjavić P. J., Gregorčič B., Oberč C., Podgoršek S. Treat-andextend therapy using intravitreal aflibercept for neovascular agerelated macular degeneration: 2-year real-world practice data from Slovenia. BMC Ophthalmol. 2018 Dec 20; 18 (1): 333. doi: 10.1186/ s12886-018-1005-x


Для цитирования:


Иошин И.Э., Аноприева Т.А. Подходы к назначению антиангиогенных препаратов при терапии пациентов с неоваскулярной возрастной макулярной дегенерацией. Российский офтальмологический журнал. 2019;12(3):102-112. https://doi.org/10.21516/2072-0076-2019-12-3-102-112

For citation:


Ioshin I.E., Anoprieva T. Principles of anti-VEGF dosing in the treatment of neovascular age-related macular degeneration. Russian Ophthalmological Journal. 2019;12(3):102-112. (In Russ.) https://doi.org/10.21516/2072-0076-2019-12-3-102-112

Просмотров: 40


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 2072-0076 (Print)
ISSN 2587-5760 (Online)