Holekamp Nancy M
Roche Pharmaceuticals in Basel, Switzerland.
Am J Ophthalmol. 2024 Nov 8. doi: 10.1016/j.ajo.2024.10.031.
To provide a perspective on the management of patients with neovascular age-related macular degeneration (nAMD) using a combination of sustained drug delivery strategies and remote monitoring technology.
Evidence-based perspective.
Review of the literature and experience of the author.
There are currently many ongoing research efforts in the retina field directed at both safe, effective sustained drug delivery and validated remote monitoring. At present, the port delivery system with ranibizumab and the Home OCT are approved by the U.S. Food and Drug Administration and available for use by clinicians. A review of available data and a case example demonstrate the potential for these combined technologies to reduce both the injection burden and the monitoring burden currently experienced by patients with nAMD. Other sustained drug delivery strategies such as tyrosine kinase inhibitor delivery systems and viral vector-mediated anti-vascular endothelial growth factor intraocular biofactory models are not yet approved for clinical use. Early experience with these technologies in clinical trials foretell the potential advantages and possible limitations of remote monitoring with a variety of sustained delivery approaches.
The combined use of sustained drug delivery and validated remote monitoring portends a significant change in the current nAMD treatment landscape and has the potential to reduce the injection and monitoring burden faced by patients while optimizing patient outcomes.
运用持续给药策略与远程监测技术相结合的方法，对新生血管性年龄相关性黄斑变性（nAMD）患者的管理提供一种观点。
基于证据的观点。
回顾文献及作者的经验。
目前视网膜领域有许多正在进行的研究工作，旨在实现安全、有效的持续给药以及经过验证的远程监测。目前，雷珠单抗眼内注射植入系统和家用光学相干断层扫描（OCT）已获美国食品药品监督管理局批准，可供临床医生使用。对现有数据的回顾及一个病例示例表明，这些联合技术有潜力减轻nAMD患者目前所经历的注射负担和监测负担。其他持续给药策略，如酪氨酸激酶抑制剂给药系统和病毒载体介导的抗血管内皮生长因子眼内生物工厂模型，尚未获批用于临床。这些技术在临床试验中的早期经验预示了采用多种持续给药方法进行远程监测的潜在优势和可能存在的局限性。
持续给药与经过验证的远程监测相结合，预示着当前nAMD治疗格局将发生重大变化，并且有可能减轻患者面临的注射和监测负担，同时优化患者的治疗效果。
