Table 3.
Structural, pharmacodynamic, and pharmacokinetic properties of different anti-VEGF agents used in the clinical management of neovascular AMD
| Aflibercept | Ranibizumab | Bevacizumab | Pegaptanib | |
|---|---|---|---|---|
| FDA approved | Yes | Yes | No (off label use) | Yes |
| Structure/composition | Human recombinant fusion protein | Humanized monoclonal antibody fragment | Whole humanized monoclonal antibody | Aptamer (synthetic oligonucleotide) |
| Size | 115 kDa | 48 kDa | 148 kDa | 28-base RNA oligonucleotide with two branched 20 kDa PEG moieties |
| Growth factor specificity | All isoforms of VEGF-A, VEGF-B, and PlGF | All isoforms of VEGF-A | All isoforms of VEGF-A | VEGF-A165 |
| Intravitreal dose for AMD (mg) | 2 | 0.5 | 1.25 | 0.3 |
| Intravitreal half lifea (days) | 4.7 | 2.9 | 4.3 | 3.9 |
Note:
a
Intravitreal half-life estimates were derived from experimental animal studies and not human eyes.
Abbreviations: VEGF, vascular endothelial growth factor; AMD, age-related macular degeneration; FDA, US Food and Drug Administration; PEG, polyethylene glycol; PIGF, placental growth factor.