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Pegpleranib (Fovista) is an investigational anti-PDGF (platelet-derived growth factor) pegylated aptamer developed by Ophthotech Corporation (now Iveric Bio, an Astellas company). It was designed to be administered in combination with anti-VEGF (vascular endothelial growth factor) therapies, such as bevacizumab (Avastin) or aflibercept (Eylea), for the treatment of neovascular (wet) age-related macular degeneration (nAMD). The therapeutic rationale was that pegpleranib would bind to PDGF-BB and strip pericytes from the neovascular membranes, thereby making the underlying endothelial cells more susceptible to the inhibitory effects of anti-VEGF agents. This dual inhibition was intended to enhance neovascular regression and improve visual outcomes compared to anti-VEGF monotherapy. However, the Phase 3 clinical trial program, including the OPH1004 trial which specifically evaluated pairings with bevacizumab or aflibercept, failed to demonstrate superiority over anti-VEGF monotherapy, leading to the termination of its development for this indication.
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