title: Ranibizumab combined with low-dose sorafenib for exudative age-related macular degeneration.
abstract: Angiogenesis is a common factor in the pathogenesis of cancer and in exudative age-related macular degeneration (AMD). Therefore, angiogenesis inhibition has been developed as a therapeutic strategy. We report 2 cases of recurrent exudative AMD in which oral sorafenib, a tyrosine kinase inhibitor approved for cancer, was added to intravitreal ranibizumab, an antibody to vascular endothelial growth factor. These 2 patients were followed up by determination of visual acuity, fluorescein angiography, fundoscopy, and optical coherence tomography. The visual acuity of 1 patient improved from 20/70 to 20/60 while he was receiving sorafenib therapy; that of the other did not. Marked improvement was noted in both patients on optical coherence tomography. Additionally, both patients appeared to receive some benefit when low-dose oral sorafenib was used as monotherapy after its initial addition to ranibizumab therapy. Randomized trials of adding sorafenib to standard therapy for patients with neovascular AMD should be considered.
authors.affiliation: Department of Ophthalmology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Diago
authors.forename: Jose S
authors.initials: JS
authors.lastname: Pulido
authors.forename: Julian R
authors.initials: JR
authors.lastname: Molina
authors.forename: Lucienne C
authors.initials: LC
authors.lastname: Collett
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Link
authors.forename: Edwin H
authors.initials: EH
authors.lastname: Ryan
mesh_terms: D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D001557:Benzenesulfonates / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005451:Fluorescein Angiography; D006801:Humans; D008268:Macular Degeneration / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage*; D011725:Pyridines / Q000008:administration & dosage*; D011859:Radiography; D000069579:Ranibizumab; D012008:Recurrence; D000077157:Sorafenib
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib; D000069579:Ranibizumab