Ranibizumab
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
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 [1], under the brand name Lucentis.
Contents |
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.
Side 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
- Earthtimes article notes FDA approval in June, 2006
- Medical News Today cites two clinical trials in New England Journal of Medicine
- 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
Humanized monoclonal antibodies ("-zu-") | |
|---|---|
| "-tuzu-" (tumor) | Alemtuzumab, Bevacizumab/Ranibizumab, Bivatuzumab mertansine, Cantuzumab mertansine, Dacetuzumab, Etaracizumab, Etaratuzumab, Gemtuzumab ozogamicin, Inotuzumab ozogamicin, Labetuzumab, Lintuzumab, Matuzumab, Nimotuzumab, Pertuzumab, Sibrotuzumab, Sontuzumab, Tacatuzumab tetraxetan, Trastuzumab, Tucotuzumab celmoleukin |
| "-lizu-" (immune system) | Aselizumab, Atlizumab, Apolizumab, Cedelizumab, Certolizumab pegol, Daclizumab, Eculizumab, Efalizumab, Epratuzumab, Erlizumab, Fontolizumab, Ibalizumab, Lebrilizumab, Mepolizumab, Natalizumab, Ocrelizumab, Omalizumab, Pascolizumab, Pexelizumab, Reslizumab, Rovelizumab, Ruplizumab, Siplizumab, Talizumab, Teplizumab, Tocilizumab, Toralizumab, Visilizumab |
| "-bazu-" (bacterial) | Tefibazumab |
| "-cizu-" (cardiovascular) | Bevacizumab, Tadocizumab |
| "-neuzu-" (nervous system) | Bapineuzumab |
| "-toxazu-" (toxin as target) | Urtoxazumab |
| "-vizu-" (viral infections) | Felvizumab, Motavizumab, Palivizumab, PRO 140 |
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
