R E V I E W Anecor tave acetate in the treatment of age-related macular degeneration Albert Augustin Department of Ophthalmology, Moltkestrasse 90, 76133 Karlsruhe, Germany Correspondence:Albert Augustin Department of Ophthalmology, Moltkestrasse 90, 76133 Karlsruhe, Germany Tel +49 721 9742001 Fax +49 721 9742009 Email 106020.560@compuserve.com Abstract: RETAANE® 15mg (anecortave acetate suspension) is under investigation to treat exudative age-related macular degeneration (AMD), the single largest cause of blindness in the Western world, affecting over 15 million people in the USA. RETAANE suspension is a unique synthetic cortisene and has antiangiogenic properties that were established in multiple experimental models of angiogenesis. The molecule acts at multiple sites of the angiogenic cascade. Clinical trials in patients with exudative AMD have demonstrated the excellent safety record of both the drug anecortave acetate and the posterior juxtascleral depot (PJD) administration procedure. A pivotal study comparing RETAANE suspension with placebo showed a significantly higher chance of maintaining vision in the treatment (73%) as compared with placebo (47%). Another study compared RETAANE suspension with Visudyne® photodynamic therapy, revealing no statistically significant differences between the two treatments over 24 months. AMD is a multi-faceted disease and therefore a molecule such as RETAANE suspension with a unique mechanism of action, demonstrated clinical efficacy, and retreatment every six months is an important potential treatment option which should be further investigated both as a monotherapy or in combination with other treatment strategies. Keywords: age-related macular degeneration (AMD), anecortave acetate, RETAANE suspension, exudative AMD, progression of dry AMD Introduction – current treatment options Age-related macular degeneration (AMD) is the most serious threat to the vision of the elderly. It is the leading cause of severe and permanent central vision loss amongst those over 50 (Swann and Lovie-Kitchin 1990). About 10% of the population over the age of 52 and up to 33% of those over 75 present with any signs of AMD. Over 15 million Americans are already afflicted with a form of the disease and the number is rising at the rate of 2 million new cases every year. According to the European office of AMD Alliance International, an estimated 2.8 million cases of wet AMD will be diagnosed in the 25 European countries within the next decade. With such an imminent threat to the vision of the elderly, significant research and development efforts are being devoted to finding effective treatment methods for wet AMD. Currently available treatments include laser photocoagulation, verteporfin photodynamic therapy (PDT) (Visudyne®, Novartis AG, Basel, Switzerland), pegaptanib sodium injection (Macugen®, Eyetech Pharmaceuticals/Pfizer), and anecortave acetate (RETAANE® suspension, Alcon Laboratories, Inc., Fort Worth, Texas, USA). In addition, modified PDT treatments such as the combination of PDT with intravitreal triamcinolone became very popular within the last year (Augustin and Schmidt-Erfurth 2006). Anecortave acetate is a promising new treatment option that is being clinically tested and recently approved in Australia for treating AMD patients with classic containing lesions. Until 2000, laser photocoagulation was the only approved Clinical Interventions in Aging 2006:1(3) 237–246 2006 Dove Medical Press Limited. All rights reserved 237