Treatment of Wet AMD

TREATMENT OF WET MACULAR DEGENERATION WITH ANTI-VEGF MEDICATIONS

The compounds known as Vascular Endothelial Growth Factors, or VEGF’s, are found in high concentration inside the eyes of patients with wet macular degeneration, and have been proven to be one of the causes for the formation of abnormal blood vessels below the retina that cause bleeding and sudden loss of vision.

The United States Food and Drug Administration (FDA) has now approved three drugs for injection into the eye that block VEGF’s, one of which has even been shown to improve vision.

The FDA-approved drugs are Lucentis and Eyelea. Avastin, a cancer drug used to shrink tumors, is also used off-label.

With the anti-VEGF treatments, doctors are now more optimistic than ever with respect to the treatment of wet macular degeneration. However, studies have shown that in most patients, the effect is usually temporary, and patients may require monthly injections of these medications for continued effect. Additional studies are underway with new medications that have different mechanisms, and longer-acting inserts that dissolve slowly over a long time.

Most interesting is that Genentech, the company that manufactures Lucentis, also manufactures the colon cancer anti-VEGF drug known as Avastin that might also prove useful in the treatment of wet macular degeneration. Dr. Philip Rosenfeld of the renowned Bascom Palmer Eye Institute in Miami, Florida was the first to use Avastin in the eyes of wet macular degeneration patients. Like Lucentis, he found vision improvement. And while Lucentis costs $2,000 per injection, Avastin costs only $50.00.

Which of these two Genentech products works better?

No one knows. Many physicians are using the less expensive Avastin “off-label,” because it is not FDA approved. But the National Eye Institute feels that it warrants more investigation, and will fund a study to compare their relative safety and effectiveness of Lucentis and Avastin.