title: Pharmacokinetic evaluation of pegaptanib octasodium for the treatment of diabetic edema.
abstract: BACKGROUND
  Diabetic macular edema (DME) is a leading cause of visual impairment in patients with diabetic retinopathy. Pegaptanib octasodium (Macugen) was the first anti-VEGF agent approved for the treatment of neovascular age-related macular degeneration. It is a selective anti-VEGF agent, which only blocks VEGF. It has been shown to be safe and effective in treatment of DME in randomized controlled trials and it may be a safer first-line treatment in patients with diabetes with a predisposition to cardiovascular risk factors.
  
  
  METHODS
  This review covers the pharmacokinetics of pegaptanib octasodium. The authors also evaluate pegaptanib octasodium's clinical efficacy, safety and tolerability in DME.
  
  
  CONCLUSIONS
  DME is the most common cause of visual loss in patients with diabetes. Pegaptanib has been found to be more effective than laser therapy alone for center-involving DME, its efficacy might be slightly worse than other pan-VEGF blockers, but the number of patients that have significant improvement of vision after treatment are similar to those treated with pan-VEGF blockers. As a selective VEGF blocker, it may have a better ocular and systemic safety profile than pan-VEGF blocking agents. It is reasonable to consider pegaptanib as the first-line treatment for center-involving DME with pan-VEGF blockers reserved for non-responders.
authors.affiliation: Oxford University NHS Trust, Division of Ophthalmology , Healey Way, Oxford, OX3 9DY , UK +01865 234736, +0845 556 1253, +0207 467 5470, +01865 234 987 ; victor@eretina.org , victor@eretina.com , victor.chong@eye.ox.ac.uk.
authors.forename: Rupal
authors.initials: R
authors.lastname: Morjaria
authors.forename: Ngai Victor
authors.initials: NV
authors.lastname: Chong
mesh_terms: D000818:Animals; D052157:Aptamers, Nucleotide / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy / Q000473:pathology; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014786:Vision Disorders / Q000188:drug therapy / Q000209:etiology
chemical_list: D052157:Aptamers, Nucleotide; D042461:Vascular Endothelial Growth Factor A; C495058:pegaptanib
keywords: Macugen; diabetic macular edema; expert review; pegaptanib octasodium