Aflibercept (Eylea) differs from ranibizumab and bevacizumab in its mechanism of anti-VEGF action primarily because:
- A It is a recombinant fusion protein (VEGF trap) that binds VEGF-A, VEGF-B, and placental growth factor (PlGF) ✓
- B It is a monoclonal antibody with higher VEGF-A affinity
- C It inhibits VEGF by blocking its receptor tyrosine kinase intracellularly
- D It selectively inhibits VEGF-C and VEGF-D involved in lymphangiogenesis
Correct answer: A. It is a recombinant fusion protein (VEGF trap) that binds VEGF-A, VEGF-B, and placental growth factor (PlGF)
Explanation
Aflibercept is a VEGF trap — a recombinant fusion protein combining the binding domains of VEGFR-1 (domain 2) and VEGFR-2 (domain 3) with an Fc region of IgG1. It binds VEGF-A, VEGF-B, and placental growth factor (PlGF) with higher affinity than naturally occurring VEGF receptors and with greater affinity than ranibizumab or bevacizumab for VEGF-A. Binding PlGF may additionally suppress inflammatory neovascular signals. Brolucizumab and faricimab are newer agents; none work via intracellular tyrosine kinase inhibition in clinical ocular use.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.