Anti‐VEGF for wet AMD ‐ Which drug and how often?

Abstract

Introduction of anti‐VEGF agents as a treatment option of neovascular AMD (ex AMD) in 2004 have brought dramatic progression in the treatment of that disease and until now it is a gold standard for ex AMD management. In that course we will present following subjects concerning ex AMD treatment with the use of anti‐VEGF drugs. We will present a variety of anti‐VEGF agents used now for ex AMD treatment: ranibizumab, aflibercept, brolucizumab, faricimab. We will discuss the differences between these drugs, in terms of efficacy and safety. Results from clinical trials and real life observations will be presented. Novel drug‐faricimab will be presented as bispecific antibody‐which inhibits both angiopoietin‐2 and VEGF‐A which possesses superior therapeutic action in reducing vascular leaking and inflammatory responses. The rules of different regiments of anti‐VEGF treatment will be discussed‐ fixed, PRN (pro re nata), TREX (treat and extend). We will discuss as well two important problems: When to switch to the other drug in ex AMD treatment and which were the results of the treatment of patients with ex AMD during the COVID‐19 pandemic. New therapeutic strategies in ex AMD will be presented as research in under way to develop novel anti‐VEGF agents with longer duration of action and to identify new methods of delivery with long‐ term release of anti‐VEGF medication as intraocular implants.