Ranibizumab

Ranibizumab

Ranibizumab (trade name Lucentis) is a monoclonal antibody fragment derived from the same parent murine antibody as bevacizumab (Avastin). It is much smaller than the parent molecule and has been affinity matured to provide stronger binding to VEGF-A. It is an anti-angiogenic that has been approved to treat the "wet" type of age-related macular degeneration (ARMD), a common form of age-related vision loss.

Ranibizumab was developed by Genentech and is marketed in the United States by Genentech and elsewhere by Novartis [ [http://www.gene.com/gene/products/information/tgr/lucentis/factsheet.html Lucentis Fact Sheet from Genentech ] ] , under the brand name Lucentis.

Mechanism of action

Ranibizumab binds to and inhibits all subtypes of vascular endothelial growth factor A (VEGF-A). VEGF may trigger the growth of new vessels, which may leak blood and fluid into the eye. These leaky blood vessels may contribute to macular edema and choroidal neovascularization, resulting in the wet type of ARMD.

By blocking VEGF-A in the eye, ranibizumab may prevent and reverse vision loss caused by wet macular degeneration.

Administration

The drug is injected intravitreally (into the vitreous humour of the eye) once a month. If monthly injections are not feasible, the regimen may be reduced to 1 injection every 3 months after the first 4 months.

However, dosing every 3 months is linked to a loss of approximately 5 letters (1 line) in visual acuity for the following 9 months as compared with dosing on a monthly basis. Large phase 3 clinical trials (MARINA and ANCHOR) which randomized patients with wet macular degeneration showed that 95% of ranibizumab-treated patients maintained visual acuity compared with 62% of those administered placebo (P < .01) at 1 year; moreover, up to 40% demonstrated an improvement in vision of at least 3 lines. Vision maintenance and loss were defined as a loss of less than 15 letters and a gain of 15 or more letters in visual acuity, respectively, as measured using the Early Treatment of Diabetic Retinopathy eye chart.

ide effects

The most common side effects in clinical trials were conjunctival hemorrhage, eye pain, vitreous floaters, increased intraocular pressure, and intraocular inflammation.

Although there is a theoretical risk for arterial thromboembolic events in patients receiving VEGF-inhibitors by intravitreal injection, the observed incidence rate was low (< 4%) and similar to that seen in patients randomized to placebo.

Serious adverse events related to the injection procedure occurred with an incidence rate of less than 1% and included endophthalmitis, retinal detachment, and traumatic cataracts. Other serious ocular adverse events observed among ranibizumab-treated patients (incidence rate, < 2%) included intraocular inflammation and increased intraocular pressure.

External links

* [http://www.amdsupport.ca/articles/54/1/Lucentis-Coverage-in-Canada-exists-in-Quebec-amp-Ontario/Page1.html Lucentis Coverage in Canada]
* [http://www.earthtimes.org/articles/show/9159.html Earthtimes] article notes FDA approval in June, 2006
* [http://www.medicalnewstoday.com/healthnews.php?newsid=53457 Medical News Today] cites two clinical trials in New England Journal of Medicine
* [http://www.sciencedaily.com/upi/index.php?feed=Science&article=UPI-1-20061004-18162600-bc-us-lucentis-analysis.xml Science Daily] clarifies that although the "wet" type of macular degeneration treated by Lucentis accounts for only 10–20% of ARMD, this type causes 90% of blindness due to ARMD.

References


Wikimedia Foundation. 2010.

См. также в других словарях:

  • Ranibizumab — Masse/Länge Primärstruktur 48,4 kDa …   Deutsch Wikipedia

  • Ranibizumab — es un medicamento que ha sido aprobado para el tratamiento de la Degeneracion macular asociada a la edad (DMAE) en su forma húmeda o exudativa.[1] Contenido 1 Descripción 2 Efectos secundarios …   Wikipedia Español

  • ranibizumab — noun A monoclonal antibody fragment derived from the same parent murine antibody as bevacizumab, used as an antiangiogenic …   Wiktionary

  • Bevacizumab — Masse/Länge Primärstruktur 149 kDa …   Deutsch Wikipedia

  • Macular degeneration — Classification and external resources Picture of the fundus showing intermediate age related macular degeneration. ICD 10 …   Wikipedia

  • Dégénérescence maculaire liée à l'âge — CIM 10 : H35.3 La dégénérescence maculaire liée à l âge (DMLA) est une maladie de la rétine provoquée par une dégénérescence progressive de la macula, partie centrale de la rétine, qui apparaît le plus souvent à partir de l âge de 50 ans, et …   Wikipédia en Français

  • Makuladegeneration — Klassifikation nach ICD 10 H35.3 Degeneration der Makula und des hinteren Poles …   Deutsch Wikipedia

  • Genentech — Infobox Company company name = Genentech, Inc. company company type = Public (NYSE: [http://quotes.nasdaq.com/asp/summaryquote.asp?symbol=DNA%60 selected=DNA%60 DNA] ) company slogan = In business for life foundation = 1976 location = South San… …   Wikipedia

  • Bevacizumab — drugbox type = mab source = Human target = VEGF CAS number=216974 75 3 ATC prefix=L01 ATC suffix=XC07 PubChem=(none) DrugBank=BTD00087 molecular weight = approx. 149,000 kDa bioavailability= 100% (IV only) metabolism = ? elimination half life= 20 …   Wikipedia

  • Choroidal neovascularization — (CNV) is the creation of new blood vessels in the choroid layer of the eye. This is a common symptom of the degenerative maculopathy wet AMD (age related macular degeneration).[1] Contents 1 Causes 2 Symptoms …   Wikipedia


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