Study Supports Treatment Choices for Wet AMD
A groundbreaking study shows that two drugs originally developed to treat different diseases in different parts of the body are equally good at improving vision in people with the “wet” form of age-related macular degeneration (AMD). This important clinical study offers ophthalmologists and patients more choice in treating this sight-stealing disease. AMD is the leading cause of blindness in the United States, affecting more than 2 million Americans age 50 and older.
The study, led by Dan Martin, MD, of the Cleveland Clinic, compared bevacizumab (Avastin™) and ranibizumab (Lucentis™) in the treatment of neovascular, or “wet,” AMD — in which abnormal blood vessels grow under the macula (the area of the eye responsible for central, detailed vision). Both drugs inhibit the growth and leakage of these abnormal vessels. Treatment frequency patterns were the same for patients receiving either drug. In both groups of patients vision improved in 25 to 34 percent of the AMD-affected eyes, and more than 90% of affected eyes were protected from further vision loss.
Avastin was not originally intended for AMD treatment, but was designed and FDA-approved for infusion into a patient's bloodstream to treat different forms of cancer. Based on its ability to inhibit abnormal blood vessels, ophthalmologists started using Avastin “off label” to treat wet AMD in 2005. Avastin is not FDA-approved for AMD. Lucentis was approved by the FDA in 2006 specifically for use in the eye as a wet AMD treatment. It is significantly more expensive than Avastin for doctors and patients.
For unknown reasons, some wet AMD patients do not respond to one drug but get positive results with the other. Ophthalmologists need the flexibility to prescribe either medication to provide the best care for their patients. This research confirms for ophthalmologists that Lucentis and Avastin are similarly effective in treating wet AMD, and also provides clearer guidance on treatment frequency.
The American Academy of Ophthalmology worked closely with Dr. Martin and his team, the National Eye Institute (NEI) and the Centers for Medicare & Medicaid Services (CMS) to help lay the foundation for this study and for further research comparing treatment effectiveness. The study is published in the New England Journal of Medicine.