Use of a VEGF antagonist to treat angiogenic eye disorders
The present invention provides methods for treating or preventing diabetic retinopathy, e.g., nonproliferative diabetic retinopathy, by sequentially administering multiple doses of a VEGF antagonist to a patient. The methods of the present invention include the administration of a 2 mg aflibercept by intravitreal injection q8 weeks after three or five initial monthly doses (2q8) or 2 mg q16 weeks after three initial monthly doses and one 8-week interval (2q16). Moreover, the present invention provides methods for reversing or halting the progression NPDR to PDR (e.g., such that the DRSS is reduced by 2 or 3 levels) or preventing the occurrence or reoccurrence of a vision threatening complication by administering aflibercept according to the dosing regimens set forth herein.
1. A method for treating diabetic retinopathy in a patient in need of such treatment, said method comprising administering, to an eye of the patient,
(i) an initial dose;
(ii) a 2nd dose one month after the initial dose;
(iii) a 3rd dose one month after 2nd dose;
(iv) a 4th dose 8 weeks after the 3rd dose; and then
(v) one or more doses every 16 weeks starting after the 4th dose;
of about 2 mg of VEGF antagonist that is a VEGF receptor-based chimeric molecule.
2. The method of claim 1 wherein the patient is administered the VEGF antagonist by intravitreal injection.
3. The method of claim 2 wherein the VEGF antagonist comprises
(1) a VEGFR1 component comprising amino acids 27 to 129 of SEQ ID NO:2;
(2) a VEGFR2 component comprising amino acids 130-231 of SEQ ID NO:2; and
(3) a multimerization component comprising amino acids 232-457 of SEQ ID NO:2.
4. The method of claim 2 , wherein the VEGF antagonist is aflibercept.
5. The method of claim 2 , wherein the VEGF antagonist comprises
(1) an immunoglobin-like (Ig) domain 2 of VEGFR1;
(2) Ig domain 3 of VEGFR2, and
(3) a multimerizing component.
6. The method of claim 2 , wherein the VEGF antagonist is conbercept.
7. The method of claim 4 wherein the patient suffers from nonproliferative diabetic retinopathy.
8. The method of claim 4 wherein the patient suffers from moderately severe or severe nonproliferative diabetic retinopathy.
9. The method of claim 4 wherein the patient suffers from nonproliferative diabetic retinopathy which is characterized by a Diabetic Retinopathy Severity Scale level of 47 or 53.
10. The method of claim 4 wherein the patient does not suffer from diabetic macular edema or center involved diabetic macular edema.
11. The method of claim 4 wherein the patient has a baseline best-corrected visual acuity (BCVA) ETDRS letter score of 69 or greater.
12. The method of claim 4 wherein the vision of the patient is characterized by a Snellen visual acuity of 20/40 or better.
13. The method of claim 4 , wherein the patient is human.
14. The method of claim 4 , wherein the patient is a human 18 years of age or older.
15. The method of claim 4 wherein the patient does not suffer from:
retinal neovascularization;
anterior segment neovascularization (ASNV);
vitreous hemorrhage; and/or
tractional retinal detachment.
16. The method of claim 4 wherein the patient suffers from proliferative diabetic retinopathy.
17. The method of claim 4 wherein the aflibercept is in a pharmaceutical formulation comprising 40 mg/mL aflibercept, in 10 mM sodium phosphate, 40 mM sodium chloride, 0.03% polysorbate 20, and 5% sucrose, pH 6.2.
18. The method of claim 17 wherein about 50 microliters of the pharmaceutical formulation is administered.
19. The method of claim 18 wherein the pharmaceutical formulation is administered by intravitreal injection with a syringe having a 30-gauge, ½-inch injection needle.
20. The method of claim 4 wherein the aflibercept is in a pharmaceutical formulation comprising 40 mg/mL aflibercept, histidine buffer, a sugar and a surfactant.
21. The method of claim 6 wherein the conbercept is in a pharmaceutical formulation comprising citric acid, sucrose, arginine and polysorbate 20.