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Ranibizumab

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Ranibizumab
Monoclonal antibody
TypeFab fragment
SourceHumanized (from mouse)
TargetVascular endothelial growth factor A (VEGF-A)
Clinical data
Trade namesLucentis, others
BiosimilarsByooviz,[1][2] Cimerli,[3] Ranivisio,[4] Raniviz,[5] Ranopto, Rimmyrah,[6] Susvimo,[7] Ximluci[8] ranibizumab-eqrn,[3] ranibizumab-nuna[1]
AHFS/Drugs.comMonograph
MedlinePlusa607044
License data
Pregnancy
category
Routes of
administration
Intravitreal injection
ATC code
Legal status
Legal status
Pharmacokinetic data
Elimination half-lifeApprox. 9 days[14]
Identifiers
CAS Number
DrugBank
ChemSpider
  • none
UNII
KEGG
ChEMBL
Chemical and physical data
FormulaC2158H3282N562O681S12
Molar mass48379.97 g·mol−1
 ☒NcheckY (what is this?)  (verify)

Ranibizumab, sold under the brand name Lucentis among others, is a monoclonal antibody fragment (Fab) created from the same parent mouse antibody as bevacizumab. It is an anti-angiogenic[16] that is approved to treat the "wet" type of age-related macular degeneration (AMD, also ARMD), diabetic retinopathy, and macular edema due to branch retinal vein occlusion or central retinal vein occlusion.

Ranibizumab was developed by Genentech and marketed by them in the United States, and elsewhere by Novartis,[17] under the brand name Lucentis.[14][17][18] Ranibizumab (Lucentis) was approved for medical use in the United States in June 2006,[18][14] and in the European Union in January 2007.

Medical uses

[edit]

In the United States, ranibizumab is indicated for the treatment of neovascular (wet) age-related macular degeneration, macular edema following retinal vein occlusion, diabetic macular edema, diabetic retinopathy, and myopic choroidal neovascularization.[14][19]

In the European Union, ranibizumab is indicated for the treatment of neovascular (wet) age-related macular degeneration, visual impairment due to diabetic macular edema, proliferative diabetic retinopathy, visual impairment due to macular edema secondary to retinal vein occlusion, and visual impairment due to choroidal neovascularisation.[15][2][4]

It is used for age-related wet macular degeneration.[20] Its effectiveness is similar to that of bevacizumab[21][22] and aflibercept.[23] A 2023 systematic review update found that while ranibizumab and bevacizumab provide similar functional outcomes in diabetic macular edema, there is low-certainty evidence suggesting that ranibizumab is more effective in reducing central retinal thickness than bevacizumab.[24]

Susvimo is a reformulation of ranibizumab suitable for injection via ocular implant.[25] Susvimo was approved for medical use in the United States in October 2021.[7][26]

Side effects

[edit]

A 2014 Cochrane review did not find a difference between bevacizumab and ranibizumab in deaths or total severe side effects when used for macular degeneration.[27] There, however, was not a lot of evidence, and thus this conclusion is not that certain.[27]

Ranibizumab does appear to result in a lower risk of stomach and intestinal problems.[27] It is also associated with a low rate of eye related side effects.[28]

Serious adverse events related to the injection procedure occurred with an incidence rate of less than 1% and included endophthalmitis, retinal detachment, and traumatic cataracts. Other serious ocular adverse events observed among ranibizumab-treated patients (incidence rate < 1%) included intraocular inflammation and blindness.[29]

Interactions

[edit]

No significant interactions are known.[30]

Pharmacology

[edit]

Ranibizumab is a monoclonal antibody that inhibits angiogenesis by inhibiting vascular endothelial growth factor A, a mechanism similar to that of bevacizumab.[31]

Society and culture

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[edit]

Biosimilars

[edit]

Byooviz was approved for medical use in the European Union in August 2021.[2][32]

Ranibizumab-nuna (Byooviz) was approved for medical use in the United States in September 2021.[1][19]

In India, Lupin Limited received marketing approval for its biosimilar of Ranibizumab.[33]

In June 2022, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Ranivisio, intended for the treatment of neovascular (wet) age-related macular degeneration, visual impairment due to macular edema or choroidal neovascularization, and proliferative diabetic retinopathy.[34] The applicant for this medicinal product is Midas Pharma GmbH.[34] Ranivisio was approved for medical use in the European Union in August 2022.[4][35]

Ranibizumab-eqrn (Cimerli) was approved for medical use in the United States in August 2022.[3][36]

In September 2022, the CHMP adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Ximluci, intended for the treatment of neovascular (wet) age-related macular degeneration, visual impairment due to diabetic macular edema, proliferative diabetic retinopathy, visual impairment due to macular edema secondary to retinal vein occlusion (branch RVO or central RVO), and visual impairment due to choroidal neovascularization.[37] The applicant for this medicinal product is STADA Arzneimittel AG.[37] Ximluci was approved for medical use in the European Union in November 2022.[8][38]

In November 2023, the CHMP adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Rimmyrah, intended for the treatment of neovascular (wet) age-related macular degeneration, visual impairment due to diabetic macular edema, proliferative diabetic retinopathy, visual impairment due to macular edema secondary to retinal vein occlusion (branch RVO or central RVO), and visual impairment due to choroidal neovascularization.[39] The applicant for this medicinal product is QILU PHARMA SPAIN S.L.[39] Rimmyrah is a biosimilar medicinal product that is highly similar to the reference product Lucentis (ranibizumab), which was authorized in the EU in January 2007.[39] Rimmyrah was approved for medical use in the European Union in January 2024.[6][40]

In January 2024, Sandoz signed an agreement to acquire ranibizumab-eqrn, the biosimilar version of ranibizumab branded as Cimerli from Coherus BioSciences, Inc. for an upfront cash purchase payment of US$170 million.[41][42][43]

In July 2024, the CHMP adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Ranibizumab Midas, intended for the treatment of neovascular (wet) age-related macular degeneration, visual impairment due to diabetic macular edema, proliferative diabetic retinopathy, visual impairment due to macular edema secondary to retinal vein occlusion and visual impairment due to choroidal neovascularization.[44] The applicant for this medicinal product is Midas Pharma GmbH.[44] Ranibizumab Midas is a biosimilar medicinal product and is a duplicate of Ranivisio.[44]

Economics

[edit]

Its effectiveness is similar to that of bevacizumab.[21][45] Its rates of side effects also appear similar.[27] However, ranibizumab typically costs $2,000 a dose, while the equivalent dose of bevacizumab typically costs $50.[46][47][48][49]

Genentech offered secret rebates to about 300 ophthalmologists in an apparent inducement to get them to use more ranibizumab rather than the less expensive bevacizumab. In 2008, bevacizumab cost Medicare only $20 million for about 480,000 injections, while ranibizumab cost Medicare $537 million for only 337,000 injections.[50] A small study showed no superior effect of ranibizumab versus bevacizumab in direct comparison.[51] The initial results of the larger Comparison of Age-related Macular Degeneration Treatments Trials (CATT) found that the two drugs "had equivalent effects on visual acuity when administered according to the same schedule;" however, serious adverse events were more common in the bevacizumab arm of the trial.[47]

According to a 2012 meta-analysis, the results of several subsequent head-to-head trials found that the two therapies performed equally at restoring visual acuity.[52][53] A 2012 meta-analysis focused specifically on safety issues concluded that the rates of several adverse events were higher with bevacizumab, although the absolute rates of ocular serious adverse events were low with both therapies: ocular adverse events were about 2.8 times as frequent with bevacizumab than with ranibizumab.[45]

References

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  1. ^ Jump up to: a b c d "Byooviz Nuna- ranibizumab injection, solution". DailyMed. 27 April 2022. Archived from the original on 3 August 2022. Retrieved 2 August 2022.
  2. ^ Jump up to: a b c d "Byooviz EPAR". European Medicines Agency. 23 June 2021. Archived from the original on 10 September 2021. Retrieved 9 September 2021. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  3. ^ Jump up to: a b c d "Cimerli- ranibizumab-eqrn injection, solution". DailyMed. 19 October 2022. Archived from the original on 21 January 2023. Retrieved 21 January 2023.
  4. ^ Jump up to: a b c d "Ranivisio EPAR". European Medicines Agency (EMA). 20 June 2022. Archived from the original on 6 October 2022. Retrieved 6 October 2022. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  5. ^ Jump up to: a b "Raniviz APMDS". Therapeutic Goods Administration (TGA). 8 January 2024. Archived from the original on 8 February 2024. Retrieved 7 March 2024.
  6. ^ Jump up to: a b "Rimmyrah EPAR". European Medicines Agency (EMA). 5 January 2024. Retrieved 7 September 2024.
  7. ^ Jump up to: a b c "Susvimo- ranibizumab injection, solution". DailyMed. Archived from the original on 19 December 2021. Retrieved 19 December 2021.
  8. ^ Jump up to: a b c "Ximluci EPAR". European Medicines Agency. 14 September 2022. Archived from the original on 13 March 2023. Retrieved 3 March 2023. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  9. ^ Jump up to: a b "AusPAR: Ranibizumab". Therapeutic Goods Administration (TGA). 9 December 2014. Archived from the original on 21 September 2021. Retrieved 20 September 2021.
  10. ^ Jump up to: a b "Byooviz APMDS". Therapeutic Goods Administration (TGA). 6 September 2022. Retrieved 7 March 2024.
  11. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
  12. ^ "Summary Basis of Decision - Byooviz". Health Canada. 12 August 2022. Archived from the original on 29 September 2022. Retrieved 29 September 2022.
  13. ^ "Summary Basis of Decision for Ranopto". Drug and Health Products Portal. 1 September 2012. Retrieved 23 July 2024.
  14. ^ Jump up to: a b c d e "Lucentis- ranibizumab injection, solution". DailyMed. Archived from the original on 21 September 2021. Retrieved 20 September 2021.
  15. ^ Jump up to: a b "Lucentis EPAR". European Medicines Agency. 17 September 2018. Archived from the original on 10 September 2021. Retrieved 9 September 2021. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  16. ^ Heidary F, Hitam WH, Ngah NF, George TM, Hashim H, Shatriah I (March 2011). "Intravitreal Ranibizumab for Choroidal Neovascularization in Best's Vitelliform Macular Dystrophy in a 6-Year-Old Boy". Journal of Pediatric Ophthalmology and Strabismus. 48 Online (6): e19–e22. doi:10.3928/01913913-20110308-02. PMID 21417187. Archived from the original on 1 October 2021. Retrieved 1 October 2021.
  17. ^ Jump up to: a b "Lucentis Fact Sheet". Genentech. Archived from the original on 28 October 2012. Retrieved 28 October 2012.
  18. ^ Jump up to: a b "Drug Approval Package: Lucentis (Ranibizumab) NDA #125156". U.S. Food and Drug Administration (FDA). 26 September 2006. Archived from the original on 2 August 2022. Retrieved 2 August 2022.
  19. ^ Jump up to: a b "FDA Approves First Biosimilar to Treat Macular Degeneration Disease and Other Eye Conditions". U.S. Food and Drug Administration (FDA) (Press release). 20 September 2021. Archived from the original on 20 September 2021. Retrieved 20 September 2021. Public Domain This article incorporates text from this source, which is in the public domain.
  20. ^ Ramin S, Soheilian M, Habibi G, Ghazavi R, Gharebaghi R, Heidary F (2015). "Age-Related Macular Degeneration: A Scientometric Analysis". Medical Hypothesis, Discovery & Innovation in Ophthalmology. 4 (2): 39–49. PMC 4458325. PMID 26060829.
  21. ^ Jump up to: a b Formoso G, Marata AM, Magrini N, Bero L (September 2014). Tovey D (ed.). "A clearer view of evidence in treating macular degeneration: off-label policies and independent research". The Cochrane Database of Systematic Reviews. 9 (9): ED000090. doi:10.1002/14651858.ED000090. PMC 10845851. PMID 25228121.
  22. ^ Solomon SD, Lindsley K, Vedula SS, Krzystolik MG, Hawkins BS (August 2014). "Anti-vascular endothelial growth factor for neovascular age-related macular degeneration". The Cochrane Database of Systematic Reviews. 8 (8): CD005139. doi:10.1002/14651858.CD005139.pub3. PMC 4270425. PMID 25170575.
  23. ^ Sarwar S, Clearfield E, Soliman MK, Sadiq MA, Baldwin AJ, Hanout M, et al. (February 2016). "Aflibercept for neovascular age-related macular degeneration". The Cochrane Database of Systematic Reviews. 2016 (2): CD011346. doi:10.1002/14651858.CD011346.pub2. PMC 5030844. PMID 26857947.
  24. ^ Virgili G, Curran K, Lucenteforte E, Peto T, Parravano M, et al. (Cochrane Eyes and Vision Group) (June 2023). "Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis". The Cochrane Database of Systematic Reviews. 2023 (6): CD007419. doi:10.1002/14651858.CD007419.pub7. PMC 10294542. PMID 38275741.
  25. ^ "Susvimo Prescribing Information" (PDF). Genentech, Inc. Archived (PDF) from the original on 13 July 2024. Retrieved 23 July 2024.
  26. ^ "Susvimo: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Archived from the original on 3 August 2022. Retrieved 2 August 2022.
  27. ^ Jump up to: a b c d Moja L, Lucenteforte E, Kwag KH, Bertele V, Campomori A, Chakravarthy U, et al. (September 2014). Moja L (ed.). "Systemic safety of bevacizumab versus ranibizumab for neovascular age-related macular degeneration". The Cochrane Database of Systematic Reviews. 9 (9): CD011230. doi:10.1002/14651858.CD011230.pub2. PMC 4262120. PMID 25220133.
  28. ^ Schmucker C, Ehlken C, Agostini HT, Antes G, Ruecker G, Lelgemann M, et al. (2012). "A safety review and meta-analyses of bevacizumab and ranibizumab: off-label versus goldstandard". PLOS ONE. 7 (8): e42701. Bibcode:2012PLoSO...742701S. doi:10.1371/journal.pone.0042701. PMC 3411814. PMID 22880086.
  29. ^ Haberfeld H, ed. (2009). Austria-Codex (in German) (2009/2010 ed.). Vienna: Österreichischer Apothekerverlag. ISBN 978-3-85200-196-8.[page needed]
  30. ^ Ranibizumab Archived 29 August 2021 at the Wayback Machine, Lexi-Drugs. Ranibizumab. Lexi-Comp, Inc.; 2007.
  31. ^ "ranibizumab". medscape. Archived from the original on 30 March 2015. Retrieved 24 March 2015.
  32. ^ "Byooviz Product information". Union Register of medicinal products. Archived from the original on 3 March 2023. Retrieved 3 March 2023.
  33. ^ "Lupin receives CDSCO committee approval for marketing ranibizumab". www.pharmabiz.com. Archived from the original on 24 November 2021. Retrieved 24 November 2021.
  34. ^ Jump up to: a b "Ranivisio: Pending EC decision". European Medicines Agency. 22 June 2022. Archived from the original on 26 June 2022. Retrieved 26 June 2022. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  35. ^ "Ranivisio Product information". Union Register of medicinal products. Archived from the original on 3 March 2023. Retrieved 3 March 2023.
  36. ^ "FDA Approves Coherus' Cimerli (ranibizumab-eqrn) as the First and Only Interchangeable Biosimilar to Lucentis for All Five Indications, with 12 Months of Interchangeability Exclusivity" (Press release). Coherus BioSciences. 2 August 2022. Archived from the original on 3 August 2022. Retrieved 2 August 2022 – via GlobeNewswire News Room.
  37. ^ Jump up to: a b "Ximluci: Pending EC decision". European Medicines Agency (EMA). 15 September 2022. Archived from the original on 19 September 2022. Retrieved 18 September 2022. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  38. ^ "Ximluci Product information". Union Register of medicinal products. Archived from the original on 17 November 2022. Retrieved 3 March 2023.
  39. ^ Jump up to: a b c "Rimmyrah: Pending EC decision". European Medicines Agency. 10 November 2023. Archived from the original on 13 November 2023. Retrieved 5 December 2023. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  40. ^ "Rimmyrah PI". Union Register of medicinal products. 9 January 2024. Retrieved 7 September 2024.
  41. ^ "FDA Approves Ranibizumab-eqrn Biosimilar, Interchangeable with Lucentis". Pharmacy Times. 3 August 2022. Archived from the original on 19 February 2023. Retrieved 22 January 2024.
  42. ^ "Sandoz announces agreement to acquire Cimerli business from Coherus, strengthening position in US market". Sandoz (Press release). Archived from the original on 29 January 2024. Retrieved 22 January 2024.
  43. ^ "Sandoz: acquisition of ophthalmology biosimilar". MarketScreener. 22 January 2024. Archived from the original on 10 March 2024. Retrieved 22 January 2024.
  44. ^ Jump up to: a b c "Ranibizumab Midas EPAR". European Medicines Agency. 25 July 2024. Retrieved 27 July 2024. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  45. ^ Jump up to: a b Schmucker C, Ehlken C, Agostini HT, Antes G, Ruecker G, Lelgemann M, et al. (2012). "A safety review and meta-analyses of bevacizumab and ranibizumab: off-label versus goldstandard". PLOS ONE. 7 (8): e42701. Bibcode:2012PLoSO...742701S. doi:10.1371/journal.pone.0042701. PMC 3411814. PMID 22880086.
  46. ^ Whoriskey P, Keating D (7 December 2013). "An effective eye drug is available for $50. But many doctors choose a $2,000 alternative". The Washington Post. Archived from the original on 26 January 2021. Retrieved 10 September 2017.
  47. ^ Jump up to: a b Martin DF, Maguire MG, Ying GS, Grunwald JE, Fine SL, Jaffe GJ (May 2011). "Ranibizumab and bevacizumab for neovascular age-related macular degeneration". The New England Journal of Medicine. 364 (20): 1897–1908. doi:10.1056/NEJMoa1102673. PMC 3157322. PMID 21526923.
  48. ^ Henderson D (17 June 2014). "Switch From Lucentis to Avastin Could Save Medicare $18B". Medscape. Archived from the original on 29 August 2021.
  49. ^ Hutton D, Newman-Casey PA, Tavag M, Zacks D, Stein J (June 2014). "Switching to less expensive blindness drug could save medicare part B $18 billion over a ten-year period". Health Affairs. 33 (6): 931–939. doi:10.1377/hlthaff.2013.0832. PMC 4137040. PMID 24889941.
  50. ^ Pollack A (3 November 2010). "Genentech Offers Secret Rebates for Eye Drug". The New York Times. Archived from the original on 9 November 2020. Retrieved 25 February 2017.
  51. ^ Subramanian ML, Abedi G, Ness S, Ahmed E, Fenberg M, Daly MK, et al. (November 2010). "Bevacizumab vs ranibizumab for age-related macular degeneration: 1-year outcomes of a prospective, double-masked randomised clinical trial". Eye. 24 (11): 1708–1715. doi:10.1038/eye.2010.147. PMID 20885427.
  52. ^ Jiang S, Park C, Barner JC (June 2014). "Ranibizumab for age-related macular degeneration: a meta-analysis of dose effects and comparison with no anti-VEGF treatment and bevacizumab". Journal of Clinical Pharmacy and Therapeutics. 39 (3): 234–239. doi:10.1111/jcpt.12146. PMID 24635444. S2CID 23979022.
  53. ^ Chakravarthy U, Harding SP, Rogers CA, Downes SM, Lotery AJ, Culliford LA, et al. (IVAN study investigators) (October 2013). "Alternative treatments to inhibit VEGF in age-related choroidal neovascularisation: 2-year findings of the IVAN randomised controlled trial". Lancet. 382 (9900): 1258–1267. doi:10.1016/S0140-6736(13)61501-9. PMID 23870813.