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Advances and Challenges in Anti-VEGF Therapies for Retinal Diseases
SEO Optimization: Advances and Challenges in Anti-VEGF Therapies for Retinal Diseases
The anti-VEGF therapies have transformed the treatment of retinal diseases like the neovascular (wet) macular degeneration, he diabetic macular edema y las retinal vein occlusions. However, the frequency of injections and the burden of treatment for the patient remain key challenges. The primary goal is to maintain vision while minimizing the impact on the patient's life.
Anti-VEGF Treatment Strategies: Balancing Efficacy and Convenience
There are three main approaches to managing anti-VEGF therapies:
- Fixed Dose (FIDO): Offers solid visual results but it implies a high treatment load with very frequent injections (approximately 11 per year), which significantly impacts the patient's time and costs.
- A Necessity (PRN – Pro Re Nata): It reduces the number of injections (4 to 8 per year), but carries the risk of undertreatment and possible long-term vision loss if the disease flares up between visits.
- Treat and Extend (TNE – Treat and Extend): Considering the scheme favorite According to many specialists, the TNE seeks a balance between eficacia visual and lower treatment burden. It begins with frequent injections, and if the eye remains stable, the intervals are gradually extended. This allows for maintaining visual results similar to the fixed dose with fewer injections (8 to 10 per year on average).
Anti-VEGF Drugs and Future Innovations
Anti-VEGF Drugs and Future Innovations
- Current drugs: Aflibercept (Aflivers) and Ranibizumab (Ran Bisumab) They are effective in the TNE scheme, allowing longer intervals. Bevacizumab (Bebas Isumap) it is a cheaper option used "off label", with debates about possible systemic risks.
- New drugs: Brolucizumab (Brulusumap) it promised longer intervals, but raised concerns about intraocular inflammation. Faricimab (Farisim) it is a promising development that targets two pathways and seeks to extend intervals up to 16 weeks. Higher doses of existing drugs and the entry of biosimilars that could reduce costs.
The Burden of Treatment and Patient Adherence
The treatment burden goes beyond the injection and includes time, logistics, emotional aspects and dependency. This burden is a key factor in the low adhesion of the patients, explaining the gap between clinical trial results and daily practice. Optimal adherence is vital to maintaining long-term vision gains.
The Future: Fewer Injections, Greater Impact
The research focuses on reduce the frequency of treatment without compromising efficacy. Key pathways include:
- Long-acting drugs: Like Faricimab, looking at intervals of three or four months.
- Sustained-release implantable devices: Small reservoirs that release medication continuously for months (e.g. Sus Bimo), drastically reducing the need for injections, although they do require initial surgery.
- Gene therapy: A transformative approach that seeks to have the eye continuously produce the anti-VEGF protein, with the potential for a single-dose treatment that lasts for years.
In conclusion, the choice of anti-VEGF strategy should be individualized, seeking maximize vision and minimize treatment burden. The field is rapidly moving toward less common options, which will improve patient adherence and quality of life.
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