Pharmacological Advances in the Treatment of Age-related Macular Degeneration

Abstract

Age-related macular degeneration is an acquired degenerative disease that is responsible for severe loss of vision in elderly people. There are two types: dry age-related macular degeneration and wet age-related macular degeneration. Its treatment has been improved and tries to be tailored in the future. The aim of this review is to summarize the pharmacological advances in the treatment of age-related macular degeneration. Regarding dry AMD, there is no effective treatment to reduce its progression. However, some molecules such as lampalizumab and eculizumab were under investigation, although they have shown low efficacy. Herein, in an attempt to prevent dry AMD progression, the most important studies suggested increasing the antioxidants intake and quitting the smoke habit. On the other hand, wet AMD has more developed treatment. Nowadays, the gold standard treatment is anti-VEGF injections. However, more effective molecules are currently under investigation. There are different molecules under research for dry AMD and wet AMD. This fact could help us treat our patients with more effective and lasting drugs but more clinical trials and safety studies are required in order to achieve an optimal treatment.

Degeneration-Dependent Retinal Remodeling: Looking for the Molecular Trigger

“…Neovascularization is driven primarily by an increase in vascular-endothelial growth factor (VEGF). Most available anti-AMD treatments are designed to reduce or slowdown neovascularization, using monoclonal antibodies against VEGF or its receptor (Gil-Martinez et al, 2020). However, there is currently no treatment that can prevent or stop the death of photoreceptors, let alone reverse it.…”

Preclinical challenges for developing long acting intravitreal medicines

“…45 Other longer acting protein therapies that are in clinical trials include abicipar pegol (Allergan) and ForSight VISION4's port delivery system (PDS) for ranibizumab (Genentech). 22,46 Phase IIII studies (HAWK and HARRIER) showed 12 week treatment interval with brolucizumab, a humanised single chain variable antibody fragment of 28 kDa. A 6.0 mg intravitreally injected dose of brolucizumab has been shown to be non-inferior in the mean change in best-corrected visual acuity from baseline to an 8 week treatment interval with aflibercept for wAMD.…”

“…51 Abicipar pegol is a PEGylated conjugate of a type of protein known as a Designed Ankyrin Repeat Protein (DARPin). 22 The CEDAR and SEQUOIA trials showed abicipar pegol at 8 or 12 week dosing to be non-inferior to Lucentis ® 4 week dosing for wAMD. 52 The PDS allows a continuous delivery of ranibizumab to the vitreous 53 from a non-biodegradable system 54 and is currently in Phase III clinical trials.…”

“…This strategy would be based on maintaining a clinically beneficial low intraocular level of VEGF to reduce the number of maintenance intravitreal injections over time. 22 Low, reproducible vitreal dosing and systemic toxicities are potential limitations for these strategies.…”

Green and ecofriendly synthesis of indole‐condensed benzimidazole chalcones in water and their antimicrobial evaluations

“…Huan et al reported silica‐supported silver nanoparticles as solid, recyclable catalysts for Diels−Alder cycloadditions of 2′‐hydroxychalcones and dienes in high yield and turnover number. Maria et al reported that copper nanoparticles supported on activated carbon catalyzed the multicomponent synthesis of indolizines from pyridine‐2‐carbaldehyde derivatives, secondary amines, and terminal alkynes in dichloromethane. All the above reported reactions use a highly expensive catalyst and nongreen solvents.…”