As the population continues to age, the need for medical advancements for age-related diseases is growing in tandem with no signs of slowing down. The field of ophthalmology is no exception. Serious eye conditions that can lead to blindness, including glaucoma, age-related macular degeneration (AMD), diabetic retinopathy, diabetic macular edema (DME) and retinal vein occlusion, are just the largest drivers of blindness among 65 people part and older. These diseases can be deeply distressing for millions of affected individuals, their loved ones and caregivers. As the number of people afflicted by these diseases increases as the population ages, these diseases also have an increasing impact on the entire healthcare system and our society.
AMD in particular affects as many as 11 million Americans. About 15% of those affected have neovascular or wet AMD. It is a devastating disease that can lead to irreversible vision loss. In fact, wet AMD is the leading cause of blindness in the United States for people age 50 and older.
Wet AMD occurs when abnormal blood vessels grow in the back of the eye and damage the macula, caused by an abnormal increase in vascular endothelial growth factor (VEGF) in the retina. VEGF in the retina may be produced due to impaired blood supply, resulting in insufficient oxygen supply to the cells inside. As a result, these vessels can leak fluid, sometimes whole blood, in the retina, causing damage to the retinal structure and scarring in its layers. Without early and frequent treatment, central vision may gradually decrease or be completely lost over time.
Symptoms of wet AMD may include blurring of the center of the vision, straight lines that appear wavy, colors that appear dull and faded, blind spots or patches, and objects that appear farther away than they actually are. Complete blindness is rare, but central vision decreases or is lost over time. In addition, there are multiple factors that increase an individual’s risk of developing wet AMD, such as age, ethnicity (which appears to be more prevalent in Caucasians), genetic/family history, smoking, alcohol consumption, and cardiovascular disease.
Trends, challenges and solutions in the treatment of wet AMD
Existing therapeutic prospects for wet AMD have significant room for improvement. Currently, most wet AMD patients are treated with eye injections every two months. This intense treatment regimen is an ongoing challenge for patients, caregivers, and physicians.
Although there are many available drugs that are considered effective in this area — requiring regular, continuous intraocular injections — they are often considered uncomfortable, intimidating, and inconvenient to the point that compliance can compromise become a problem. And we know from the large database of information that has been studied that, over time, for many patients, their severe eye condition continues to worsen their vision — not because of treatment effects, but because of lack of Treatment compliance.
For example, the most common methods for managing wet AMD today include anti-vascular endothelial growth factor (anti-VEGF) therapy, which works by stopping the growth of abnormal blood vessels and reducing leakage. Conventional treatment with anti-VEGF therapy may help reduce or prevent the causes of vision loss associated with wet AMD. Currently, there are several anti-VEGF treatments on the market. These treatments are recommended through intravitreal (back of the eye) injections approximately monthly for the first three months, followed by intravitreal injections every eight weeks.
Current anti-VEGF treatments are effective and safe, but they are not as durable and long-acting as patients really need because they have to see their doctor every month or two for injections for the rest of their time into their eyes. Life. We know that in the real world, after a year or two of illness, patients can lose most of the visual gain they get from these drugs because they can’t come back as often as needed, or because the treatment interval is longer than they should be.
Upcoming new treatments
New solutions are underway to preserve the long-term patient benefits of anti-VEGF drugs. One potential therapy in development is EYP-1901, EyePoint Pharmaceuticals’ investigational anti-VEGF treatment initially being studied in wet AMD. The investigational therapy is sustained-release, meaning it can maintain treatment intervals for up to six months or more in most wet AMD patients after a single injection. Another similar therapeutic therapy is OTX-TKI from Ocular Therapeutics. They used a hydrogel that encapsulates the anti-VEGF drug, and were also designed to sustain patients for up to six months.
In addition, there are other therapeutic approaches and drug delivery systems that promise to reduce treatment burden and improve outcomes. Gene therapies include Regenxbio’s RGX-314, an anti-VEGF treatment that has the potential to block VEGF for years after surgery, and Adverum Biotechnologies’ ADVM-022, which can be injected through an in-office procedure and has shown promise in clinical trials. Additional treatments, including studies of pan-VEGF inhibition (multiple VEGF targets) and other anti-VEGF therapies, represent the next wave of innovation in serious eye diseases, with a focus on improving the longevity of action and the durability of treatment, thereby reducing patient The burden of their caregivers and the burden of going to the doctor every month or two while maintaining their vision.
As we look to the future, I am heartened by the many advances ophthalmology has made in addressing the most serious eye diseases that can lead to blindness. As the prevalence of these diseases continues to grow as our population ages, they represent an opportunity for the biopharmaceutical industry to continue to follow the science to demonstrate the value of these treatments to providers and the entire healthcare system. Most importantly, impact the lives of patients and loved ones affected by these devastating diseases.
PHOTO: KAREN BLEIER/AFP, GETTY IMAGES
