Pharmacogenetics of the treatment response of age-related macular degeneration with ranibizumab and bevacizumab

Semin Ophthalmol. Sep-Nov 2013;28(5-6):355-60. doi: 10.3109/08820538.2013.825292. Epub 2013 Sep 6.

Abstract

Introduction: Age-related macular degeneration is a major cause of blindness among people aged 50 and older in industrialized countries. Anti-VEGF therapy has been tremendously successful in the treatment of neovascular macular degeneration. Examining the pharmacogenetics of patients' response to the anti-VEGF molecules could allow for a tailored treatment strategy based on patients' underlying genetics rather than the "one-size fits all" approach currently used.

Methods: Review of the English literature for papers examining the pharmacogenetics of treatment response of neovascular macular degeneration to either ranibizumab or bevacizumab. Polymorphisms in CFH, ARMS2, HTRA1 and VEGF A were examined and reviewed.

Results: Patients with the high-risk CC genotype in complement factor H (CFH) had a worse response to therapy with ranibizumab and bevacizumab. No clear trends were found with ARMS2, HTRA1 and VEGF A.

Conclusions: The goal of personalized medicine is to craft a treatment program that is ideally suited to an individual patient's disease and genetic make-up rather than simply what works for a large population who share similar disease characteristics. Continued research is needed to achieve this goal for the treatment of age-related macular degeneration.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Bevacizumab
  • Complement Factor H / genetics
  • High-Temperature Requirement A Serine Peptidase 1
  • Humans
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / genetics*
  • Pharmacogenetics
  • Precision Medicine
  • Proteins / genetics
  • Ranibizumab
  • Serine Endopeptidases / genetics
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vascular Endothelial Growth Factor A / genetics

Substances

  • ARMS2 protein, human
  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • CFH protein, human
  • Proteins
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Complement Factor H
  • High-Temperature Requirement A Serine Peptidase 1
  • HtrA1 protein, human
  • Serine Endopeptidases
  • Ranibizumab