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In vitro studies using retinal neurosensory and pigment epithelial cell lines in culture are aiming to define the relative safety profiles of combination corticosteroids and anti-vascular endothelial growth factor (VEGF) agents being considered for intravitreal treatment of retinal diseases.
Irvine, CA-Researchers using in vitro cell models to examine the effects of combinations of corticosteroids and anti-vascular endothelial growth factor (VEGF) agents on retinal neurosensory and pigment epithelial cells are hoping the results will provide guidance for optimizing clinical treatment protocols.
Baruch Kuppermann, MD, PhD, professor of ophthalmology and biomedical engineering, University of California at Irvine, recently discussed the findings of laboratory studies performed to investigate the cytotoxicity profiles of triamcinolone acetonide or dexamethasone combined with either bevacizumab (Avastin, Genentech) or ranibizumab (Lucentis, Genentech). The results indicated better safety of the anti-VEGF drugs when used in combination with dexamethasone than when used with triamcinolone. The study demonstrated no differences in the cell viability profiles between the two anti-VEGF agents when used in combination with either corticosteroid. Evidence existed, however, that bevacizumab and ranibizumab, when used in combination with either steroid, may have different effects on upregulating apoptosis of pigment epithelial cells, and those results favored ranibizumab.
"When interpreting these data for their clinical relevance, it is important to emphasize that the findings from a laboratory study performed using cultured cells are not necessarily predictive of what will happen in humans," Dr. Kuppermann said. "However, with that limitation in mind, previous work from our laboratory as well as from other researchers investigating the in vitro toxicity of various medications, dyes, and other compounds used in the eye have been predictive and/or corroborative of clinical outcomes. Therefore, a clinical correlation for the current study findings is certainly a possibility."