Vascular endothelial growth factors

血管内皮生长因子
  • 文章类型: Practice Guideline
    新生血管性年龄相关性黄斑变性(nAMD)是不可逆视力丧失的主要原因。目前的共识提供了关于诊断的建议,评估,治疗,以及11名执业眼科医生对nAMD的随访策略。专家建议,nAMD管理的基线访问应包括通过视觉和解剖学评估组成的多模式方法进行全面的眼科检查。诊断为nAMD的患者应接受治疗,目的是维持视觉功能,同时减少解剖学疾病活动并最大程度地减少治疗负担。目前,抗VEGF治疗是nAMD的主要治疗策略,建议在完成包括3次每月注射的负荷阶段后1个月内进行全面眼科检查的评估,以指导后续管理.在抗VEGF治疗的维持阶段,可以考虑采用治疗和延长或前纳塔方案。应根据疾病活动选择和调整治疗方案,报销标准,财政负担,和患者偏好。如果nAMD不活跃或治疗效果不佳,经过全面评估和患者教育,可以停止抗VEGF治疗。该共识为眼科医生和其他医疗保健专业人员提供了实用的nAMD管理指南。
    Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss. The present consensus provides suggestions on diagnosis, evaluation, treatment, and follow-up strategies for nAMD from a panel of 11 practicing ophthalmologists. The experts suggest that the baseline visit for nAMD management should include a comprehensive ophthalmologic examination via a multimodal approach consisting of visual and anatomical evaluation. Patients diagnosed with nAMD should be subjected to treatment with the goal of maintaining visual function while diminishing anatomical disease activity and minimizing treatment burden. Currently, anti-VEGF therapy is the main treatment strategy for nAMD, and evaluation involving comprehensive ophthalmologic examination within 1 month of completion of the loading phase comprising three monthly injections is recommended to guide subsequent management. Either a treat-and-extend or pro re nata regimen can be considered for the maintenance phase of anti-VEGF therapy, and the regimen should be chosen and adjusted according to disease activity, reimbursement criteria, financial burden, and patient preferences. In the event of inactive nAMD or poor treatment outcomes, after thorough evaluation and patient education, anti-VEGF therapy may be stopped. The consensus provides practical nAMD management guidelines for ophthalmologists and fellow healthcare professionals.
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  • 文章类型: Journal Article
    息肉状脉络膜血管病变(PCV)是一种普遍存在的视网膜疾病,主要发生在亚洲人中,在新生血管性年龄相关性黄斑变性中具有一些相似之处。最近关于玻璃体内抗血管内皮生长因子(VEGF)药物和光动力疗法(PDT)的大型多中心临床试验已经阐明了PCV的管理。台湾国民健康保险在批准所需的数据提交后,为PCV患者授予了有限的抗VEGF药物和PDT,尤其是眼底血管造影,光学相干层析成像,和视力。为了最好地利用这些有限的资源为患者,举行了一次专家会议,为PCV的管理提供最新的台湾共识建议,包括初始治疗选择,评估治疗反应,再治疗/抢救治疗,并确定治疗延期/随访时间表。提出了一种在初始和再治疗设置下进行治疗分配的算法。需要进一步的机械和临床研究来研究预后因素和最佳治疗方案,以提高医疗保健质量并减轻PCV患者的疾病和治疗负担。
    Polypoidal choroidal vasculopathy (PCV) is a prevalent retinal disease predominantly occurs in Asians that shares some similarities seen in neovascular age-related macular degeneration. Recent large multicenter clinical trials on intravitreal anti-vascular endothelial growth factor (VEGF) agents and photodynamic therapy (PDT) have shed lights on the management of PCV. The Taiwan National Health Insurance had granted limited anti-VEGF agents and PDT for patients with PCV after the approval of required data submission, especially fundus angiography, optical coherence tomography, and visual acuity. In order to best utilize these limited resources for the patients, an expert meeting was held to provide updated Taiwan consensus recommendations for the management of PCV, including initial therapy selection, assessment of treatment response, re-treatment/rescue treatment, and determination of treatment extension/follow-up schedule. An algorithm for treatment allocation under both initial and re-treatment setting was proposed. Further mechanistic and clinical studies are required to investigate the prognostic factors and optimal treatment protocols that will improve healthcare quality and reduce burden of disease and treatment for patients with PCV.
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  • 文章类型: Consensus Development Conference
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  • 文章类型: Journal Article
    在过去的5年中,针对晚期缺血性心脏病患者的血管生成生长因子治疗的迅速发展为基于在患病心脏中产生新的血液供应的新治疗策略提供了希望。然而,随着治疗性冠状动脉血管生成领域从基础和临床前研究到临床试验的成熟,许多新的和目前尚未解决的问题正在成为焦点。这些包括对血管生成生物学的深入理解,选择合适的患者人群进行临床试验,选择治疗终点和评估方法,治疗策略的选择(基因与蛋白质递送),给药途径,和副作用。本文介绍了在该领域积极工作的专家小组的摘要声明,由血管生成基金会和血管生成研究中心在美国心脏协会第72次会议期间召集,以定义并达成关于冠心病治疗性血管生成发展面临的挑战的共识。
    The rapid development of angiogenic growth factor therapy for patients with advanced ischemic heart disease over the last 5 years offers hope of a new treatment strategy based on generation of new blood supply in the diseased heart. However, as the field of therapeutic coronary angiogenesis is maturing from basic and preclinical investigations to clinical trials, many new and presently unresolved issues are coming into focus. These include in-depth understanding of the biology of angiogenesis, selection of appropriate patient populations for clinical trials, choice of therapeutic end points and means of their assessment, choice of therapeutic strategy (gene versus protein delivery), route of administration, and the side effect profile. The present article presents a summary statement of a panel of experts actively working in the field, convened by the Angiogenesis Foundation and the Angiogenesis Research Center during the 72nd meeting of the American Heart Association to define and achieve a consensus on the challenges facing development of therapeutic angiogenesis for coronary disease.
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