Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.
Expert Opin Biol Ther. 2022 Oct;22(10):1275-1291. doi: 10.1080/14712598.2022.2100694. Epub 2022 Jul 17.
Diabetic retinopathy (DR) is one of the most frequent microvascular complications of diabetes that can lead to blindness. Laser treatment has been the gold standard treatment for diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) for many years. Recently, the role of vascular endothelial growth factor (VEGF) has been established in the pathogenesis of DR, and the use of intravitreal anti-VEGF therapy has gained popularity for the management of DR.
This review includes a brief overview of the efficacy and safety of currently available (bevacizumab, ranibizumab, and aflibercept) and potential future (brolucizumab, faricimab, and KSI-301) anti-VEGF agents in patients with DR based mainly on publicly available data from phase 1, 2 and 3 clinical trials.
Clinical trials investigating the efficacy of intravitreal bevacizumab, ranibizumab, and aflibercept injections demonstrated favorable functional and anatomical outcomes in patients with DME. Moreover, the use of these anti-VEGF agents showed a significant improvement in the severity of DR. Recent clinical research for future anti-VEGF molecules aims to provide higher target-protein binding affinity and prolonged therapeutic effect. Brolucizumab, faricimab, and KSI-301 are three novel anti-VEGF agents that demonstrate promising data for the management of DME and potentially DR.
糖尿病视网膜病变（DR）是糖尿病最常见的微血管并发症之一，可导致失明。激光治疗多年来一直是糖尿病黄斑水肿（DME）和增生性糖尿病视网膜病变（PDR）的金标准治疗方法。最近，血管内皮生长因子（VEGF）在 DR 的发病机制中的作用已经得到确立，玻璃体内抗 VEGF 治疗在 DR 的治疗中越来越受欢迎。
这篇综述主要基于 1 期、2 期和 3 期临床试验的公开数据，简要概述了目前可用于 DR 患者的（贝伐单抗、雷珠单抗和阿柏西普）和潜在未来的（brolucizumab、faricimab 和 KSI-301）抗 VEGF 药物的疗效和安全性。
研究玻璃体内注射贝伐单抗、雷珠单抗和阿柏西普疗效的临床试验显示，DME 患者的功能和解剖学结果良好。此外，这些抗 VEGF 药物的使用显著改善了 DR 的严重程度。最近针对未来抗 VEGF 分子的临床研究旨在提供更高的靶蛋白结合亲和力和延长的治疗效果。brolucizumab、faricimab 和 KSI-301 是三种新型抗 VEGF 药物，在 DME 治疗中显示出有前途的数据，可能对 DR 也有治疗作用。
