pegaptanib

(redirected from Macugen)

pegaptanib

(peg-apt-i-nib) ,

Macugen

(trade name)

Classification

Therapeutic: ocular agents
Pharmacologic: vascular endothelial growth factor antagonists
Pregnancy Category: B

Indications

Neovascular (wet) age-related macular degeneration.

Action

Acts as an antagonist of vascular endothelial growth factor (VEGF). VEGF may be responsible for the formation of incompetent, leaky blood vessels associated with macular degeneration.

Therapeutic effects

Decreased rate of loss of visual acuity.

Pharmacokinetics

Absorption: Slowly absorbed into systemic circulation after intravitreous administration.
Distribution: Unknown.
Metabolism and Excretion: Metabolized by exo- and endonucleases.
Half-life: 10 days (plasma).

Time/action profile

ROUTEONSETPEAKDURATION
Intravitrealunknownunknown6 wk

Contraindications/Precautions

Contraindicated in: Ocular/periocular infections.
Use Cautiously in: Obstetric: Use only if maternal benefit outweighs fetal risk; Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects

Ear, Eye, Nose, Throat

  • cataract
  • blurred vision
  • conjunctival bleeding
  • irritation/pain
  • ↑ intraocular pressure
  • ocular inflammation
  • infection (rare)
  • retinal detachment (rare)
  • traumatic cataract formation (rare)

Miscellaneous

  • Anaphylaxis
  • angioedema

Interactions

Drug-Drug interaction

None known.

Route/Dosage

Intravitreal (Adults) 0.3 mg every 6 wk.

Availability

Solution for intraviteous injection: 0.3 mg/mL in 1-mL single use glass syringes

Nursing implications

Nursing assessment

  • Assess eye for signs of infection frequently during week following injection.
  • Check perfusion of optic nerve head immediately after injection, use tonometry to measure intraocular pressure within 30 min following the injection, and biomicroscopy between 2 and 7 days following injection. Increases in intraocular pressure have been seen within 30 min of injection.

Potential Nursing Diagnoses

Disturbed sensory perception (Indications)

Implementation

  • Do not administer solutions that are discolored or contain particulate matter. Attach threaded plastic threader rod to the rubber stopper inside barrel of syringe. Do not pull back on plunger.
    • Adequate analgesia and a broad-spectrum antibiotic should be given prior to injection.
  • Intravitreal: For ophthalmic intravitreal injection only.

Patient/Family Teaching

  • Advise patient to notify ophthalmologist immediately if eye becomes red, sensitive to light, painful, or develops a change in vision.

Evaluation/Desired Outcomes

  • Slowing of vision loss.
Drug Guide, © 2015 Farlex and Partners

pegaptanib

An anti-vascular endothelial growth factor agent that has been found helpful in the treatment of neovascular age-related macular degeneration. A brand name is Macugen.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
(8.) Spitzer MS, Yoeruek E, Sierra A, Wallenfels-Thilo B, Schraermeyer U, Spitzer B, Bartz-Schmidt KU, Szurman P Comparative antiproliferative and cytotoxic profile of bevacizumab (Avastin), pegaptanib (Macugen) and ranibizumab (Lucentis) on different ocular cells.
The Macugen Diabetic Retinopathy Study Group conducted a phase II RCT of pegaptanib for fovea-involving DME (48).
Pegaptanib (Macugen, Pfizer, New York), bevacizumab (Avastin, Genentech Inc., San Francisco, CA), ranibizumab (Lucentis, Genetech Inc., San Francisco, CA), and aflibercept (Eylea, Regeneron, New York) vary in their affinity for the subtypes of the VEGF molecule.
Among their topics are the development and applications of thioredoxin-based peptide aptamers, selecting and applying catalytically active oligonucleotides, stem-cell-specific aptamers for targeted cancer therapy, aptamer-liposome conjugates: current art and future prospects, molecular imaging utilizing aptamer-targeted probes, and the first therapeutic aptamer: a macugen targeting vascular endothelial growth factor.
Researchers found that participants treated with any of the three anti-VEGF agents--ranibizumab (Lucentis), bevacizumab (Avastin), and pegaptanib (Macugen)--more often had improved vision, less often lost vision, and were less likely to be legally blind after one year than those treated with control treatments.
There are three agents in this class: aflibercept (Eylea), pegaptanib (Macugen), and ranibizumab (Lucentis).
For example, intravitreal injections of therapeutics are routinely used in the treatment of wet AMD (Lucentis, Macugen, Vitravene), macular inflammation (Triesence), etc.
Currently, four intravitreal anti-VEGF agents--pegaptanib (Macugen; Pfizer Inc., NY, USA), ranibizumab (Lucentis; Genentech Inc., San Francisco, CA, USA), bevacizumab (Avastin; Genentech Inc.), and aflibercept (Eylea; Regeneron Pharmaceuticals Inc., NY, USA)--have emerged as new treatments for the more advanced stages of DR.
In the UK, the first prominent approved anti-VEGF drug was pegaptanib (Macugen), which has now been replaced by the more effective anti-VEGF agents ranibizumab (Lucentis) and aflibercept (VEGF-trap, Eylea) (14) although pegaptanib is still available for about 9,000[pounds sterling] for a two-year course.
Ranibizumab (Lucentis; Genentech, South San Francisco, CA/Roche, Basel, Switzerland, 2006), bevacizumab (Avastin; Genentech, South San Francisco, CA/Roche, Basel, Switzerland, 2005), pegaptanib sodium (Macugen; Eyetech Inc., Palm Beach Gardens, FL, 2004), and VEGF trap or Aflibercept (EYLEA; Regeneron Pharmaceutical Inc.
The search strategy used the following words: diabetic retinopathy, diabetic macular edema, vascular endothelial growth factor, anti-VEGF, pegaptanib, Macugen, bevacizumab, Avastin, ranibizumab, Lucentis, aflibercept, VEGF Trap Eye, and Eylea.
However, the achievement of Macugen has given a boost to the aptamer field.