Acupuncture Continuing Education

Macular Degeneration Avastin-Lucentis Controversy Ends

Wet age related macular degeneration (AMD) is treatable with Lucentis. Wet AMD causes vision loss due to abnormal blood vessel growth in the eye. The blood vessels bleed, leak, and cause scarring therefore severely damaging vision. The FDA has approved Lucentis (ranibizumab) for the treatment of wet AMD but many physicians favor Avastin (bevacizumab) because it is significantly less expensive and yet chemically similar. Both products are made by Genentech, the biotech pharmaceutical division of Roche.

The use of Avastin for AMD is not approved by the FDA. This off-label (non-approved) use of Avastin generates significant controversy. According to Genentech, Lucentis is a superior treatment for AMD. Many doctors favor Avastin because it costs approximately $150 per treatment compared with that of Lucentis at $2,000 per treatment. The Lucentis-Avastin controversy will end in February 2011 with the completion of the National Eye Institutes’s (NEI) clinical trials that compare the two drugs for the treatment of wet AMD. The NEI study evaluates the safety and efficacy of both Lucentis and Avastin for the treatment of AMD.

The final data collection of the study is occurring now even though the final conclusions will be officially released next year. This is a massive study chaired and directed by doctors from the Cleveland Clinic, University of Pennsylvania, and Duke University. Over 55 medical groups from California to Florida participate in this effort. This includes centers such as the Mayo Clinic in Rochester, Minnesota; the Massachusetts Eye & Ear Infirmary in Boston, the Duke University Eye Center in North Carolina, the University of Wisconsin, the West Coast Retina Medical Group in San Francisco, California; the University of California-Davis Medical Center in Sacramento, and the Retina-Vitreous Associates Medical Group in Beverly Hills, California to name a few.

The study will determine whether or not Lucentis is safer and more effective for the treatment of wet AMD over Avastin. The financial stakes are high for the biotech giant Genentech whose profits from Lucentis over Avastin for the treatment of AMD are significant. More importantly, the study will determine what is the best course of treatment for patients looking to save their eyesight. The NEI study results have not been posted yet the information is vital for patients suffering from AMD. Looking forward, will doctors and participants from the clinical trials leak anecdotal information over the course of the next year?

A separate study conducted by researchers from the Boston University School of Medicine and the VA Boston Healthcare System which appears in the American Journal of Ophthalmology concludes that there is no difference between Lucentis and Avastin for the treatment of AMD. This is hardly the final word. This study was only conducted on 20 subjects for a period of six months. At best, this study is inconclusive and on the downside this study may be inadvertently steering doctors away from using the best possible treatment for AMD. As a result of this preliminary investigation, many doctors have already concluded that there is no difference between Avastin and Lucentis. We are a year out from knowing the answer to the Lucentis-Avastin controversy. Look to February 2011 to learn the answer to this very important question that will ultimately help determine the best course of treatment for patients suffering from AMD. Once the NEI study is published in 2011, the pharmaceutical controversy is over and patients will benefit from this knowledge.

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