WO2016094673A1 - Treatment of age related macular degeneration with a small active choroidal neovascularization lesion - Google Patents

Treatment of age related macular degeneration with a small active choroidal neovascularization lesion Download PDF

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Publication number
WO2016094673A1
WO2016094673A1 PCT/US2015/065022 US2015065022W WO2016094673A1 WO 2016094673 A1 WO2016094673 A1 WO 2016094673A1 US 2015065022 W US2015065022 W US 2015065022W WO 2016094673 A1 WO2016094673 A1 WO 2016094673A1
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Prior art keywords
treatment
wamd
lesion
vegf
cnv
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Ceased
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PCT/US2015/065022
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English (en)
French (fr)
Inventor
Oliver ZEITZ
Olaf Sowade
Haiyan Wu
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Bayer Healthcare LLC
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Bayer Healthcare LLC
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Priority claimed from PCT/CN2014/093548 external-priority patent/WO2016090590A1/en
Priority to ES15819965T priority Critical patent/ES2907148T3/es
Priority to LTEPPCT/US2015/065022T priority patent/LT3230316T/lt
Priority to CN202210019267.XA priority patent/CN114306575A/zh
Priority to AU2015360496A priority patent/AU2015360496B2/en
Priority to CN201580066980.8A priority patent/CN106999511A/zh
Priority to EP15819965.3A priority patent/EP3230316B1/en
Priority to CA2970315A priority patent/CA2970315C/en
Priority to JP2017530277A priority patent/JP7320919B2/ja
Priority to US15/534,030 priority patent/US20170326106A1/en
Priority to DK15819965.3T priority patent/DK3230316T3/da
Priority to RS20220058A priority patent/RS62827B1/sr
Application filed by Bayer Healthcare LLC filed Critical Bayer Healthcare LLC
Priority to HRP20220066TT priority patent/HRP20220066T1/hr
Priority to EP21207057.7A priority patent/EP3985023A1/en
Priority to SI201531805T priority patent/SI3230316T1/sl
Priority to PL15819965T priority patent/PL3230316T3/pl
Publication of WO2016094673A1 publication Critical patent/WO2016094673A1/en
Anticipated expiration legal-status Critical
Priority to US16/453,242 priority patent/US20190381008A1/en
Priority to AU2021107575A priority patent/AU2021107575A4/en
Priority to AU2021245214A priority patent/AU2021245214B2/en
Priority to AU2024205237A priority patent/AU2024205237A1/en
Ceased legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/409Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil having four such rings, e.g. porphine derivatives, bilirubin, biliverdine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7088Compounds having three or more nucleosides or nucleotides
    • A61K31/7105Natural ribonucleic acids, i.e. containing only riboses attached to adenine, guanine, cytosine or uracil and having 3'-5' phosphodiester links
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K41/00Medicinal preparations obtained by treating materials with wave energy or particle radiation ; Therapies using these preparations
    • A61K41/0057Photodynamic therapy with a photosensitizer, i.e. agent able to produce reactive oxygen species upon exposure to light or radiation, e.g. UV or visible light; photocleavage of nucleic acids with an agent
    • A61K41/0071PDT with porphyrins having exactly 20 ring atoms, i.e. based on the non-expanded tetrapyrrolic ring system, e.g. bacteriochlorin, chlorin-e6, or phthalocyanines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0019Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0048Eye, e.g. artificial tears
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00Drugs for disorders of the senses
    • A61P27/02Ophthalmic agents
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K16/00Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
    • C07K16/18Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/22Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against growth factors ; against growth regulators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K16/00Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K2319/00Fusion polypeptide
    • C07K2319/30Non-immunoglobulin-derived peptide or protein having an immunoglobulin constant or Fc region, or a fragment thereof, attached thereto

Definitions

  • Age related macular degeneration is a medical condition that usually affects older adults and results in a loss of vision in the center of the visual field (the macula) because of damage to the retina. It occurs in “dry” and “wet” forms. In the dry form, cellular debris called drusen accumulates between the retina and the choroid, and the retina can become detached. In the wet form (wAMD), which is more severe, blood vessels grow up from the choroid behind the retina which is also named choroidal neovascularization (CNV). As a result of CNV the retina can also become detached.
  • CNV choroidal neovascularization
  • VEGF vascular endothelial growth factor
  • wAMD can be also treated with photodynamic therapy with
  • Verteporfin® V ® -PDT
  • V ® -PDT Verteporfin®
  • the CATT research group compared the baseline characteristics, treatment frequency, visual acuity (VA), and morphologic outcomes of eyes with >50% of the lesion composed of blood (B50 group) versus all other eyes (Other group) enrolled in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT).
  • Treatment for the study eye was assigned randomly to either ranibizumab or bevacizumab and to 3 different dosing regimens over a 2-year period. Reading center graders evaluated baseline and follow-up morphology in color fundus photographs, fluorescein angiography (FA), and optical coherence tomography (OCT).
  • wAMD there are two subtypes of wAMD: (I) small active CNV lesion - type of wAMD or (II) predominantly active CNV lesion - type of wAMD.
  • the location of the lesion can be subfoveal or juxtafoveal affecting the fovea.
  • the type of the lesion can be of all subtypes including predominantly classic, minimally classic, or occult.
  • Alternate terms for the "predominantly active CNV lesion - type of wAMD” may include: 1) "pCNV wAMD"
  • sCNV wAMD is characterized by an active CNV lesion that occupies less than 50% of the total lesion size
  • pCNV wAMD is characterized by an active CNV lesion that occupies at least 50% of the total lesion size.
  • the location of the lesion can be subfoveal or juxtafoveal affecting the fovea.
  • the type of the lesion can be of all subtypes including predominantly classic, minimally classic or occult.
  • the size of the active CNV lesion as well as the total lesion size is determined using Fluorescence Angiography (FA) as described in the MPS protocol [Macular Photocoagulation Study Group, Arch Ophthalmol 1991, 109: 1242-1257].
  • treatments for wAMD can be also used for the treatment of patients with "sCNV wAMD".
  • Such treatment of patients with "sCNV wAMD” may be as follows:
  • anti-VEGF therapy refers to all approved and non-approved treatments aiming to attenuate free VEGF in the eye. This includes particularly aflibercept, ranibizumab, bevacizumab, KH-902, and pegaptanib, but is not limited to these compounds.
  • Anti-VEGF treatment may be applied according to the following treatment schedules:
  • Fluoresceine Angiography Indocyanine Angiography, Funduscopy, etc. stabilizes, followed by discontinuation of treatment. Re-initiation of treatment upon deterioration of visual acuity and/or retinal morphology.
  • V ® -PDT Single or repeated applications of photodynamic therapy with Visudyne ®
  • V ® -PDT Single or repeated applications of steroids (all available local or systemic application routes) including slow-release or depot formulations (e.g. Ozurdex, triamcinolone, dexamethasone, Iluvien, etc.)
  • a total of 304 Chinese subjects with age-related neovascular or wet age-related macular degeneration were enrolled in a randomized, double-blind clinical study to assess the efficacy of intravitreal (IVT) administrated aflibercept compared with V ® -PDT on the mean change in BCVA (Best corrected visual acuity) from baseline to Week 28.
  • BCVA of the study eye was assessed according to the standard procedures developed for the ETDRS (Early Treatment Diabetic Retinopathy Study) adapted for Age Related Eye Disease Study (AREDS). The key inclusion criteria were as follows:
  • CNV choroidal neovascularization
  • juxtafoveal lesions that affect the fovea, as evidenced by fluorescein angiography (FA), in the study eye.
  • FA fluorescein angiography
  • the area of the CNV had to occupy at least 50% of the total lesion.
  • Total lesion size is greater than 12 disc areas (30.5 mm 2 , including blood, scars and
  • Sub-retinal hemorrhages that is >50% of the total lesion area, or if the blood is under the fovea and is 1 or more disc areas in size. (If the blood is under the fovea, then the fovea must be surrounded by 270 degrees by visible CNV.)
  • PCV polypoidal choroidal vasculopathy
  • the lesion size was determined by a central reading center based on the MPS protocol [Macular Photocoagulation Study Group, Arch Ophthalmol 1991, 109: 1242-1257].
  • the active CNV size, the area of CNV (mm 2 ) as well as the total lesion size was measured using the FA.
  • the central retinal thickness was determined by optical coherence tomography.
  • VTE2Q8 group patients were treated with 2 mg (0.05 mL) aflibercept administered intravitreally at baseline, week 4, 8, 16, 24, 32, 40 and 48.
  • V ® -PDT was performed at baseline and potential PDT retreatment according to the guidelines for the use of PDT treatment in wAMD [Verteporfin Roundtable Participants, Retina. 2005; 25(2): 119-34] were performed at week 12 and 24.
  • subjects in the PDT—VEGF Trap-Eye group received an IVT injection of 2.0 mg VEGF Trap-Eye, followed by additional 2.0 mg VEGF Trap-Eye injections at Weeks 32, 36, 40, and 48.
  • Intravitreal injections of 2 mg aflibercept was superior to V ® -PDT with a mean change from baseline BCVA letter score at week 28 of 14.0 (-29 to 59) VTE2Q8 group versus 3.9 (-36 to 43) PDT group (P ⁇ 0.0001) in the whole study population irrespective of the active CNV lesion size.
  • FIG 1/2 Mean change from baseline in ETDRS BCVA letter score by visit in subjects with an active CNV lesion > 50% of total lesion size at baseline.
  • the mean change in BCVA score (no. of letters) as measured by ETDRS from baseline at week 1 (V3) week 4 (V4), week 8 (V5), week 12 (V6), week 16 (V7), week 20 (V8), week 24 (V9), week 28 (VIO), Week 32 (Visit 11), Week 36 (Visit 12), Week 40 (Visit 13), Week 44 (visit 14), Week 28 (Visit 15), Week 52 (Visit 16) is shown for the VTE2Q8 group (solid line with diamonds) and the PDT->VTE group (dashed line with squares).
  • the mean change in BCVA score from baseline is 12.7 for the VTE2Q8 group and 1.5 for the PDT->VTE group.
  • the mean change in BCVA score from baseline is 14.0 for the VTE2Q8 group and 6.4 for the PDT->VTE group.
  • Figure 2/2 Mean change from baseline in ETDRS BCVA letter score by visit in subjects with an active CNV lesions ⁇ 50% of total lesion size at baseline.
  • the mean change in BCVA score (no. of letters) as measured by ETDRS from baseline at week 1 (V3) week 4 (V4), week 8 (V5), week 12 (V6), week 16 (V7), week 20 (V8), week 24 (V9), week 28 (V10), Week 32 (Visit 11), Week 36 (Visit 12), Week 40 (Visit 13), Week 44 (visit 14), Week 28 (Visit 15), Week 52 (Visit 16) is shown for the VTE2Q8 group (solid line with diamonds) and the PD->VTET group (dashed line with squares).
  • the mean change in BCVA score from baseline is 16.7 for the VTE2Q8 group and 8.0 for the PDT->VTE group.
  • the mean change in BCVA score from baseline is 18.1 for the VTE2Q8 group and 13.4 for the PDT->VTE group.

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  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Animal Behavior & Ethology (AREA)
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  • Organic Chemistry (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Immunology (AREA)
  • Proteomics, Peptides & Aminoacids (AREA)
  • Genetics & Genomics (AREA)
  • Ophthalmology & Optometry (AREA)
  • Biophysics (AREA)
  • Dermatology (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Engineering & Computer Science (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
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PCT/US2015/065022 2014-12-11 2015-12-10 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion Ceased WO2016094673A1 (en)

Priority Applications (19)

Application Number Priority Date Filing Date Title
SI201531805T SI3230316T1 (sl) 2014-12-11 2015-12-10 Zdravljenje starostne degeneracije makule z majhno aktivno horoidalno neovaskularizacijsko lezijo
PL15819965T PL3230316T3 (pl) 2014-12-11 2015-12-10 Leczenie zwyrodnienia plamki żółtej związanego z wiekiem z małą aktywną zmianą neowaskularyzacji naczyniówki
RS20220058A RS62827B1 (sr) 2014-12-11 2015-12-10 Tretman staračke degeneracije žute mrlje koja ima malu aktivnu leziju neovaskularizacije sudovnjače
CN202210019267.XA CN114306575A (zh) 2014-12-11 2015-12-10 具有小的活动性脉络膜新生血管病变的年龄相关性黄斑变性的治疗
AU2015360496A AU2015360496B2 (en) 2014-12-11 2015-12-10 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion
CN201580066980.8A CN106999511A (zh) 2014-12-11 2015-12-10 具有小的活动性脉络膜新生血管病变的年龄相关性黄斑变性的治疗
EP15819965.3A EP3230316B1 (en) 2014-12-11 2015-12-10 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion
CA2970315A CA2970315C (en) 2014-12-11 2015-12-10 Use of anti-vegf agents to treat lesions in macular degeneration patients
HRP20220066TT HRP20220066T1 (hr) 2014-12-11 2015-12-10 Liječenje makularne degeneracije povezane sa starenjem s malom aktivnom koroidnom neovaskularizacijskom lezijom
LTEPPCT/US2015/065022T LT3230316T (lt) 2014-12-11 2015-12-10 Gydymas su amžiumi susijusios geltonosios dėmės degeneracijos su mažu aktyvios choroidinės neovaskuliarizacijos pažeidimu
DK15819965.3T DK3230316T3 (da) 2014-12-11 2015-12-10 Behandling af aldersrelateret makuladegeneration med en lille aktiv choroidal neovaskularisationslæsion
ES15819965T ES2907148T3 (es) 2014-12-11 2015-12-10 Tratamiento de la degeneración macular asociada a la edad con una pequeña lesión de neovascularización coroidea activa
US15/534,030 US20170326106A1 (en) 2014-12-11 2015-12-10 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion
JP2017530277A JP7320919B2 (ja) 2014-12-11 2015-12-10 小さい活動性脈絡膜新生血管病変を有する加齢黄斑変性症の治療
EP21207057.7A EP3985023A1 (en) 2014-12-11 2015-12-10 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion
US16/453,242 US20190381008A1 (en) 2014-12-11 2019-06-26 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion
AU2021245214A AU2021245214B2 (en) 2014-12-11 2021-10-08 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion
AU2021107575A AU2021107575A4 (en) 2014-12-11 2021-10-08 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion
AU2024205237A AU2024205237A1 (en) 2014-12-11 2024-07-31 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
PCT/CN2014/093548 WO2016090590A1 (en) 2014-12-11 2014-12-11 Treatment of age related macular degeneration with a small active choroidalneovascularizationlesion
CNPCT/CN2014/093548 2014-12-11
CN2015089251 2015-09-09
CNPCT/CN2015/089251 2015-09-09

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US15/534,030 A-371-Of-International US20170326106A1 (en) 2014-12-11 2015-12-10 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion
US16/453,242 Continuation US20190381008A1 (en) 2014-12-11 2019-06-26 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion

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PCT/US2015/065022 Ceased WO2016094673A1 (en) 2014-12-11 2015-12-10 Treatment of age related macular degeneration with a small active choroidal neovascularization lesion

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US (2) US20170326106A1 (https=)
EP (2) EP3985023A1 (https=)
JP (3) JP7320919B2 (https=)
CN (3) CN114306575A (https=)
AU (4) AU2015360496B2 (https=)
CA (1) CA2970315C (https=)
DK (1) DK3230316T3 (https=)
ES (1) ES2907148T3 (https=)
HR (1) HRP20220066T1 (https=)
HU (1) HUE057653T2 (https=)
LT (1) LT3230316T (https=)
PL (1) PL3230316T3 (https=)
PT (1) PT3230316T (https=)
RS (1) RS62827B1 (https=)
SI (1) SI3230316T1 (https=)
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US11103552B2 (en) 2018-05-10 2021-08-31 Regeneron Pharmaceuticals, Inc. High concentration VEGF receptor fusion protein containing formulations
EP3230316B1 (en) 2014-12-11 2022-01-05 Bayer HealthCare LLC Treatment of age related macular degeneration with a small active choroidal neovascularization lesion
US12503503B2 (en) 2018-10-29 2025-12-23 Hoffmann-La Roche Inc. Bispecific anti-VEGF/ANG2 antibody formulation

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AU2012323856B2 (en) 2011-10-13 2017-05-25 EyePoint, Inc. Methods for treating Vascular Leak Syndrome and cancer
US9840553B2 (en) 2014-06-28 2017-12-12 Kodiak Sciences Inc. Dual PDGF/VEGF antagonists
US10525035B2 (en) * 2014-12-18 2020-01-07 Lankenau Institute For Medical Research Methods and compositions for the treatment of retinopathy and other ocular diseases
KR102799807B1 (ko) 2015-12-30 2025-04-24 코디악 사이언시스 인코포레이티드 항체 및 이의 접합체
CN111699004A (zh) * 2018-02-06 2020-09-22 豪夫迈·罗氏有限公司 眼科疾病的治疗
MX2020009152A (es) 2018-03-02 2020-11-09 Kodiak Sciences Inc Anticuerpos de il-6 y constructos de fusion y conjugados de los mismos.
CN120058958A (zh) 2018-09-24 2025-05-30 视点制药公司 靶向HPTP-β(VE-PTP)和VEGF的多特异性抗体
CN118718181A (zh) 2019-06-05 2024-10-01 里珍纳龙药品有限公司 用于精确剂量递送的装置及方法
CA3157509A1 (en) 2019-10-10 2021-04-15 Kodiak Sciences Inc. Methods of treating an eye disorder
US11944663B2 (en) * 2020-06-18 2024-04-02 Chengdu Kanghong Biotechnologies Co. Ltd. Method for treating angiogenic eye disorders using VEGF antagonists
USD1120314S1 (en) 2022-11-30 2026-03-24 Regeneron Pharmaceuticals, Inc. Dose delivery device
WO2025047970A1 (ja) * 2023-08-31 2025-03-06 国立大学法人京都大学 光感受性物質含有リポタンパク質、光線力学的療法用製剤、薬物デリバリー方法及び後眼部新生血管閉塞方法

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US11103552B2 (en) 2018-05-10 2021-08-31 Regeneron Pharmaceuticals, Inc. High concentration VEGF receptor fusion protein containing formulations
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