Ranibizumab

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Ranibizumab is an active ingredient from the group of VEGF inhibitors. Ranibizumab is a humanised recombinant monoclonal antibody fragment (Fab V2) of the monoclonal antibody Bevacizumab. It is produced by means of recombinant DNA from the bacterium Escherichia coli.

Pharmacodynamics (Effect)
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VEGF combines proteins of different groups, which as signal molecules fulfil different tasks in human vascular tissues. VEGF-A is important for angiogenesis (formation of new vessels) in the eye. Ranibizumab binds to all forms of VEGF-A, thus preventing receptor activation with the downstream signalling cascade. Ranibizumab thus reduces the formation of new retinal vessels and the development of retinal edema (Mantel I et al. 2018).

Indication
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wet age-related macular degeneration, diabetic macular edema, macular edema after vein occlusion

Undesirable effects
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The most common side effects of ranibizumab are: conjunctival hemorrhage; eye pain; cataracts; floaters; increased intraocular pressure; vitreous detachment; serious side effects are eye infections (endophthalmitis) and retinal detachment.

Literature
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  1. Cai S et al (2017) Aflibercept, bevacizumab or ranibizumab for diabetic macular oedema: recent clinically relevant findings from DRCR.net Protocol T. Curr Opin Ophthalmol 28:636-643.
  2. Dugel PU et al (2017) Brolucizumab Versus Aflibercept in Participants with Neovascular Age-Related Macular Degeneration: A Randomized Trial. Ophthalmology 124:1296-1304.
  3. Freund KB et al (2015) Treat-and extend regimens with anti-VEGF agents in retinal diseases. Retina. 35:1489–1506
  4. Mantel I et al (2018) Switching between ranibizumab and aflibercept for the treatment of neovascular age-related macular degeneration. Surv Ophthalmol 63:638-645.
  5. Moreno TA et al (2016) Ranibizumab (Lucentis) versus Bevacizumab (Avastin) for the Treatment of Age-Related Macular Degeneration: An Economic Disparity of Eye Health. Semin Ophthalmol 31:378-384.
  6. Sangroongruangsri S et al (2018) Comparative efficacy of bevacizumab, ranibizumab, and aflibercept for treatment of macular edema secondary to retinal vein occlusion: a systematic review and network meta-analysis. Expert Rev Clin Pharmacol 11:903-916.
  7. Wang L et l. (2018) Clinical effectiveness of ranibizumab and conbercept for neovascular age-related macular degeneration: a meta-analysis. Drug of Devel Ther 12:3625-3633.

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Last updated on: 29.10.2020