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ENGLISH ABSTRACT
关注新生血管性年龄相关性黄斑变性的创新药物治疗
卢颖毅
赵晶
戴虹
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20231225-00217
Focusing on innovative drug therapy for neovascular age-related macular degeneration
Lu Yingyi
Zhao Jing
Dai Hong
Authors Info & Affiliations
Lu Yingyi
Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Zhao Jing
Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Dai Hong
Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
·
DOI： 10.3760/cma.j.cn115989-20231225-00217
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摘要

湿性年龄相关性黄斑变性(nAMD)是老年人致盲的主要原因，抗VEGF是其主要治疗方法。目前，nAMD治疗仍面临诸多不足和挑战，开发新的治疗药物和给药方法是其主要研究的方向。近年来治疗nAMD的药物研发方向呈现多样化，包括开发新靶点/新机制药物及新型给药方式、优化给药剂量和基因疗法等，达到降低治疗频率、延长治疗间隔、提高患者治疗依从性和长期维持或改善视力的目的。眼科临床医师应对新的药物有较为全面的了解，进而发掘出适合不同nAMD亚型患者的优化方案，实现向精准化医疗迈进。

年龄相关性黄斑变性;治疗;抗VEGF;创新药物
ABSTRACT

Wet age-related macular degeneration (nAMD) is the leading cause of blindness in the elderly, and anti-VEGF is its main treatment method.At present, the treatment of nAMD still faces many shortcomings and challenges, and the development of new therapeutic drugs and delivery methods is the research focus.In recent years, the direction of drug research and development for the treatment of nAMD has shown diversification, including the development of new target/mechanism drugs and new drug delivery methods, optimization of drug dosage and gene therapy, etc., in order to reduce treatment frequency, prolong treatment interval, improve patient compliance, and maintain or improve vision in the long term.Ophthalmologists should have a comprehensive understanding of new drugs and explore strategies appropriate for patients with different subtypes of nAMD to achieve a move toward precision medicine.

Age-related macular degeneration;Treatment;Anti-VEGF;Innovative drug
Dai Hong, Email: tendef.3ab62xgnoh-iad
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引用本文

卢颖毅,赵晶,戴虹. 关注新生血管性年龄相关性黄斑变性的创新药物治疗[J]. 中华实验眼科杂志,2024,42(05)：401-407.

DOI:10.3760/cma.j.cn115989-20231225-00217

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年龄相关性黄斑变性(age-related macular degeneration，AMD)是全球老年人群视力受损和致盲的主要病因。据估计，2040年全球AMD患者数量将增长至2.88亿 [ 1 ]，2050年我国AMD患者数量可能增长至5 519万 [ 2 ]。基于病理特征可将AMD分为新生血管性(湿性或渗出性)和非新生血管性(干性或萎缩性)。新生血管性AMD(neovascular age-related macular degeneration，nAMD)约占AMD总发病人群的10%～20%，而约90%出现中心视力急性下降乃至盲的AMD患者是由nAMD病变引起的 [ 3 , 4 ]。
目前nAMD的一线治疗方案——玻璃体腔内注射抗血管内皮生长因子(vascular endothelial growth factor，VEGF)药物，虽可明显改善患者视功能，但需频繁注射，加重了患者治疗负担，导致患者治疗依从性降低，从而影响患者视力预后，同时也增加了不良事件发生的风险 [ 5 , 6 ]。部分nAMD患者对抗VEGF药物治疗反应不佳或无应答 [ 7 ]。真实世界报道也提示，nAMD患者长期治疗视力仍难以维持 [ 8 ]。因此，nAMD的临床治疗仍存在诸多挑战。
近年来治疗nAMD的药物研发方向呈现多样化，包括开发新靶点/新机制药物及新型给药方式、优化给药剂量和基因疗法等，以期增加药物疗效、延长给药间隔时间或减少眼内药物的注射频率。其中，部分创新药物已经成功研发并上市(如法瑞西单抗、布西珠单抗)，部分新药或新的治疗方式也在不同阶段的临床试验中取得了突破性进展，有望进一步提高患者治疗依从性和长期维持或改善视力，nAMD的创新治疗值得关注和期待。
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戴虹，Email： tendef.3ab62xgnoh-iad
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首都卫生发展科研专项 (2020-2-4051)
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