Wouldn’t it be nice if patients with age-related macular degeneration (AMD) could receive their anti-VEGF agents topically, rather than by intravitreal injection? A cyclic retro-inverted peptidomimetic, D(Cys-Leu-Pro-Arg-Cys) – also known as Vasotide – is the latest candidate for that role.

Vasotide works by selectively binding to the VEGF receptors VEGFR-1 and neuropilin-1 (NRP-1), and pilot studies performed in young mice with a retinopathy of prematurity-like phenotype showed that topical administration of the drug inhibited retinal angiogenesis (1). What’s now been published are the results of preclinical evaluations in three animal models: a mouse oxygen-induced retinopathy, vldr-null mice (a mouse model of retinal angiomatous proliferation), and laser-induced choroidal neovascularization in Old World monkeys (2). In the latter experiment, topically-formulated Vasotide was administered twice daily from day 1 through day 5 after laser photocoagulation, then once daily on days 6 through 21. On retinal assessment at day 29, Vasotide use was associated with a significant (p<0.0001) reduction in the development of grade III and IV lesions compared with monkeys treated with vehicle alone – an outcome comparable to those achieved by ranibizumab or bevacizumab in this model.