Key result
Simultaneous targeting of the VEGF and Ang/Tie pathways, particularly with faricimab, shows promising results in phase II/III trials for the management of exudative macular diseases.
Why the study?
High treatment burden and non-responders to anti-VEGF agents in exudative retinal diseases highlighted the need for alternative approaches targeting the Ang/Tie pathway.
Simultaneous targeting of the VEGF and Ang/Tie pathways, particularly with agents like faricimab, may provide a more beneficial therapeutic approach than VEGF monotherapy for exudative retinal diseases.
May expand options for exudative retinal diseases; leaves open confirmation of durability and superiority in larger trials.
INTRODUCTION: Several approaches have been investigated for treating wet age-related macular degeneration (w-AMD), diabetic macular edema (DME) and retinal vein occlusions (RVOs). The first-line treatment for these exudative retinal diseases consists of anti-vascular endothelial growth factor (VEGF) agents; however, the high treatment burden and the percentage of 'non responder' patients have highlighted the need for other approaches. Increasing evidence has shown the role of angiopoietin/Tie (Ang/Tie) pathway in the pathogenesis of these exudative retinal diseases; therefore, novel drugs targeting this pathway are under evaluation in clinical trials. AREAS COVERED: We analyzed the novel, emerging drugs (ARP- 1536, the coformulation of aflibercept and nesvacumab, AXT107 and AKB-9778) that target the Ang/Tie pathway. These drugs are still in early phase clinical trials, but encouraging outcomes have emerged. We also discuss the clinical efficacy of faricimab, a bispecific monoclonal antibody that inhibits VEGF-A and Ang-2. EXPERT OPINION: The simultaneous targeting of the VEGF and Ang/Tie pathways may be more beneficial than monotherapy in patients with exudative retinal diseases. Among the investigational drugs targeting the Ang/Tie pathway, faricimab has shown promising results in phase II/III trials and in the near future may represent a viable treatment option for the management of exudative macular diseases.
No takes yet. Share an insight, caveat, or question.
Desideri et al. (2022) conducted a review in Exudative retinal diseases (wet age-related macular degeneration, diabetic macular edema, and retinal vein occlusions). Drugs targeting the Angiopoietin/Tie pathway (e.g., faricimab, ARP-1536, nesvacumab, AXT107, AKB-9778) was evaluated. Simultaneous targeting of the VEGF and Ang/Tie pathways, particularly with faricimab, shows promising results in phase II/III trials for the management of exudative macular diseases.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: