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抗血管内皮生长因子疗法治疗年龄相关性黄斑变性继发的黄斑下脉络膜新生血管:II期研究结果

Anti-vascular endothelial growth factor therapy for subfoveal choroidal neovascularization secondary to age-related macular degeneration: phase II study results.

出版信息

Ophthalmology. 2003 May;110(5):979-86. doi: 10.1016/S0161-6420(03)00085-X.

Abstract

PURPOSE

There is evidence to suggest that anti-vascular endothelial growth factor (anti-VEGF) therapy may be useful in treating ocular neovascularization. A phase IA single intravitreal injection study of anti-VEGF therapy for patients with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) revealed a good safety profile. We performed a phase II multiple injection study of anti-VEGF therapy with and without photodynamic therapy for patients with subfoveal CNV secondary to AMD to determine the safety profile of multiple injection therapy.

DESIGN

A phase II multiple-dose safety study.

PARTICIPANTS/METHODS: Twenty-one patients were treated with intravitreal injection with and without photodynamic therapy.

MAIN OUTCOME MEASURES

Clinical evidence of toxicity and complications.

RESULTS

No drug-related serious adverse events were revealed. Ophthalmic evaluation revealed that 87.5% of patients who received the anti-VEGF aptamer alone showed stabilized or improved vision 3 months after treatment and that 25% of eyes demonstrated a 3 line or greater improvement in vision on the Early Treatment of Diabetic Retinopathy Study chart during this period. A 60% 3 line gain at 3 months was noted in patients who received both the anti-VEGF aptamer and photodynamic therapy.

CONCLUSIONS

Anti-VEGF therapy is a promising treatment for various forms of ocular neovascularization, including AMD. Multiple intravitreal injections of the anti-VEGF aptamer were well tolerated in this phase II study. Further clinical trials are necessary to demonstrate the efficacy and long-term safety of anti-VEGF therapy for AMD.

摘要

目的

有证据表明抗血管内皮生长因子(抗VEGF)疗法可能有助于治疗眼部新生血管。一项针对年龄相关性黄斑变性(AMD)继发的黄斑中心凹下脉络膜新生血管(CNV)患者的IA期玻璃体内单次注射抗VEGF疗法研究显示出良好的安全性。我们对AMD继发黄斑中心凹下CNV患者进行了一项II期多次注射抗VEGF疗法联合或不联合光动力疗法的研究,以确定多次注射疗法的安全性。

设计

一项II期多剂量安全性研究。

参与者/方法:21例患者接受了玻璃体内注射联合或不联合光动力疗法。

主要观察指标

毒性和并发症的临床证据。

结果

未发现与药物相关的严重不良事件。眼科评估显示,单独接受抗VEGF适体治疗的患者中,87.5%在治疗后3个月视力稳定或改善,在此期间,25%的患眼在糖尿病视网膜病变早期治疗研究图表上视力提高了3行或更多。接受抗VEGF适体和光动力疗法的患者在3个月时视力提高了60%(3行)。

结论

抗VEGF疗法是治疗包括AMD在内的各种形式眼部新生血管的一种有前景的治疗方法。在这项II期研究中,多次玻璃体内注射抗VEGF适体耐受性良好。需要进一步的临床试验来证明抗VEGF疗法治疗AMD的疗效和长期安全性。

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