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Anti-VEGF plus omega-3 decreases vitreal VEGF-A in AMD patients
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The combination of omega-3 supplements and anti-VEGF treatment lowered vitreous vascular endothelial growth factor A levels in patients with wet age-related macular degeneration, according to a study recently published in the American Journal of Ophthalmology.
Rezende and colleagues conducted a prospective, single-center clinical trial consecutive interventional case series study that was randomized and open label.
As detailed in the study, researchers evenly divided 40 participants into four groups for the study: 10 participants with active wet-AMD and prior anti-VEGF treatment took four capsules per day of Vitalux plus omega-3 (Alcon); 10 participants with active wet-AMD and prior anti-VEGF treatment took two capsules per day of Vitalux AREDS; 10 participants with active wet-AMD began anti-VEGF treatment; and 10 participants without wet AMD but with epiretinal membrane or macular hole underwent 25-gauge pars plana vitrectomy.
The protocol for the anti-VEGF treatment consisted of three loading doses that were followed by pro re nata injections. Patients underwent vitreal biopsies to test VEGF levels, analyze lipidomics and verify contamination.
Results showed that participants who received the omega-3 supplements had significantly lower levels of vitreal VEGF-A with 141.11 ± 61.89 pg/mL, compared to the AREDS group and the anti-VEGF beginners, with 626.09 ± 279.27 pg/mL and 735.48 ± 216.43 pg/mL, respectively. Researchers found that the omega-3 participants had similar levels of vitreal VEGF-A compared to the epiretinal membrane or macular hole participants, with 235.81 ± 33.99 pg/mL.
"Our data suggests that omega-3 supplementation selectively lowers pathological ocular VEGF-A in the retina, but not physiologic systemic VEGF-A," the authors concluded. "Long-term studies will be required to determine if the observed reduction in VEGF-A by omega-3- supplementation combined with anti-VEGF translates into lesser choroidal neovascular progression or activity."
Disclosures: The sponsors or funding organizations had no role in the design or conduct of this research. Rezende has received consultation fees from Novartis Canada, Alcon Canada, Bausch + Lomb Canada, Allergan and Bayer Canada, none of which related to the current study. Lapalme, Qian, Sangiovanni and Smith have no relevant financial disclosures. Sapieha holds a Canada Research Chair and has received consultation fees from Gerson Lehman Group, not related to the current research.
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