Topical Triamcinolone Acetonide-Loaded Liposome Formulation Used as an Adjuvant to Intravitreal Ranibizumab Therapy for Neovascular Age-Related Macular Degeneration

Abstract

Novel strategies have been developed to reduce or avoid intravitreal injections (IVTs) of the antiangiogenic (ranibizumab (RBZ)) and anti-inflammatory (triamcinolone acetonide (TA)) agents used to treat vitreoretinal diseases. One of the strategies includes liposomes. This study evaluated the safety and efficacy of a topical triamcinolone-loaded liposome formulation (TALF) as an adjuvant to intravitreal RBZ therapy in treatment- naïve patients with neovascular age-related macular degeneration (nAMD). Subjects were randomly assigned to the RBZ-TALF or the RBZ-pro re nata (RBZ-PRN) groups. Patients from the RBZ-TALF group were instructed to apply TALF for 12 months after a single dose of RBZ. Patients from the RBZ-PRN group received three monthly RBZ-IVTs. Retreatment with RBZ was considered in the case of nAMD reactivation. Regarding safety, non-ocular abnormalities were observed during TALF therapy. Concerning efficacy, non-significant differences were identified in terms of visual acuity or central foveal thickness when the RBZ-PRN and RBZ-TALF groups were compared. It is worth noting that the average number of RBZ injections was significantly lower in the RBZ-TALF group (2.5 ± 1.4 vs. 6.1 ± 1.3 IVTs; p = 0.0004). Therefore, TALF used as an adjuvant to RBZ reduces the need for RBZ-IVT retreatment with optimal visual and anatomic results.

Biomimetic electrospun PVDF/self-assembling peptide piezoelectric scaffolds for neural stem cell transplantation in neural tissue engineering

“…This triggers a signaling cascade that promotes cell proliferation and differentiation. 50,51 Moreover, to corroborate these data, cell viability studies were performed using MTS assay. Cell proliferation and viability were assessed with an MTS assay (ESI Fig.…”

The Evolution of Triamcinolone Acetonide Therapeutic Use in Retinal Diseases: From Off-Label Intravitreal Injection to Advanced Nano-Drug Delivery Systems

“…No significant differences were observed between RBZ/TA-LF and RBZ groups regarding BCVA or CFT. However, the mean number of RBZ injections was significantly lower in the RBZ/TA-LF group, with 2.5 ± 1.4 versus 6.1 ± 1.3 for intravitreal injections [137].…”

Biomaterial Drug Delivery Systems for Prominent Ocular Diseases

“…More recently, however, a TA-loaded liposome formulation (TALF) was used as an adjuvant to intravitreal ranibizumab therapy for neovascular AMD. Navarro-Partida et al hypothesized that this could enhance the efficacy of ranibizumab while minimizing collateral effects through reduced doses [ 123 ]. Patients using the TALF as an adjuvant to anti-VEGF intravitreal injections reported an average of 2.5 injection retreatments throughout 12 months, which is much lower than the reported 13 injections per patient throughout 12 months in a previous large clinical trial [ 124 ].…”