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Aflibercept ophthalmic solution: drug development and clinical uses

Michael W Stewart

The recent adoption of drugs that inhibit the actions of VEGF has dramatically changed ophthalmology. The intravitreal injection of potent anti-VEGF medications, particularly bevacizumab and ranibizumab, has become standard-of-care for the treatment of the most common blinding diseases – exudative age-related macular degeneration and diabetic macular edema. The introduction of aflibercept, a high binding affinity fusion protein, gives physicians another valuable tool for the treatment of these conditions. The VIEW 1 and 2 trials showed that monthly and bimonthly aflibercept was equivalent to monthly ranibizumab for the treatment of age-related macular degeneration, and the COPERNICUS and GALILEO trials showed that aflibercept was far superior to sham injections for the treatment of macular edema due to central retinal vein occlusions. Ongoing trials are investigating the efficacy of aflibercept for the treatment of edema due to diabetic retinopathy, branch retinal vein occlusions and myopic choroidal neovascularization.