Heparin-binding VEGFR1 variants as long-acting VEGF inhibitors for treatment of intraocular neovascular disorders

Significance Vascular endothelial growth factor (VEGF) inhibitors have transformed the treatment of intraocular vascular disorders. However, the burden of frequent intravitreal injections reduces patient compliance such that the impact in the “real world” is less than in clinical trials. Thus, there is a need to discover VEGF inhibitors than can be administered less frequently. We hypothesized that the ability to bind heparan-sulfate proteoglycans may be a strategy to promote intraocular retention and increase half-life. We designed a series of VEGF receptor 1 variants and identified some with strong heparin-binding characteristics that are more effective and durable in action in animal models of intraocular neovascularization than a standard of care like aflibercept. The work should fulfill an unmet medical need and advance therapy.