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Contribution of steroids for treatment of AMD unknown
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FORT LAUDERDALE, Fla. — Inflammation is a known component of age-related macular degeneration, but the potential benefit of steroids in the treatment of AMD is still unknown, according to a speaker here.
“If you look at anti-VEGF itself, it doesn’t have much of an effect as an anti-inflammatory marker. If you look at anterior chamber fluid, you can see that over a period of time, over 12 months, there is very good inhibition with ranibizumab and VEGF but no effect on these other cytokine markers,” Marc D. de Smet, MD, PhD, FRCSC, said at the Retina World Congress.
Marc D. de Smet
Many drugs have been used to inhibit inflammation in AMD. Anti-inflammatories have been used in conjunction with anti-VEGFs with varying results. Corticosteroids, such as dexamethasone, in combination with anti-VEGFs may be useful in treating frequent immune response reoccurrences and tachyphylaxis, de Smet said.
However, a combination of steroids, anti-VEGFs and photodynamic therapy seems to be the most promising AMD treatment, de Smet said.
“What about triple therapy using PDT, steroids and as well as anti-VEGF as compared to anti-VEGF-naïve patients that have been treated previously. You don’t see any change with regards to foveal thickness. There may be slight benefit for the ones receiving ranibizumab compared to the other groups, although it’s not statistically significant. But what you do see is the delay to recurrence is higher in those that have received combined treatment and there is a much lower need for treatment in the first year,” he said.
Steroids may also be useful to reduce vascular leakage rather than to treat neovascular membrane, de Smet said. – by Robert Linnehan
Reference:
de Smet MD. Is there a role for steroids in AMD management? Presented at: Retina World Congress; Feb. 23-26, 2017; Fort Lauderdale, Fla.
Disclosure: de Smet reports relevant financial disclosures for Alcon, Allergan, Eyevensys, Janssen, Charles River Labs, NightstaRx, Oxford BioMedica Sanofi, Preceyes, Santen and ThromboGenics.