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Comparison study finds two drugs for wet macular degeneration are similar despite major cost differences.
A study that compared the effectiveness of two drugs used to treat age-related macular degeneration (AMD) has shown that the drugs, Lucentis and Avastin, are nearly equally effective. However, when it comes to cost, the drugs vary greatly, with Avastin being the significantly less costly treatment.
Oregon Health & Science University's Casey Eye Institute was one of several research centers involved in the study, called the Comparison of Age-Related Macular degeneration Treatments (CATT) Trial. The results of the trial were published in the May 2012 issue of the medical journal Ophthalmology.
Both drugs are FDA-approved and currently used to treat AMD. Lucentis (ranibizumab) is approved for treatment of the wet form of age-related macular degeneration. Avastin (bevacizumab) is used to treat certain forms of cancer. Because Avastin blocks abnormal blood vessel growth, an aspect of AMD that causes vision loss, it is used "off-label" for the disease. A single dose of Lucentis costs approximately $2,000 and a single dose of Avastin is approximately $50.
The study involved the treatment of more than 1,000 participants who received one or the other drug. Both drugs are administered via injection into the eye. Depending on each patient's progress, injections occurred as frequently as monthly and less often in other cases. Vision acuity was tracked throughout the study and at the end of two years, results were nearly identical for both groups of patients.
“Both drugs act by blocking a key protein that causes the abnormal growth of blood vessels in the eye, “explained retina specialist Christina Flaxel, M.D. , principal investigator of the study at Casey and professor of ophthalmology in the OHSU School of Medicine.
“Both drugs have a unique method for blocking this protein, but the results appear to be approximately the same when it comes to vision impacts.”
In particular, findings after two years included: 1) The two drugs had similar effects on vision when the dosing schedules were the same; 2) The vision effects changed little from the one-year results; 3) Patients who received monthly injections with either drug had slightly better vision; 4) There was no difference in side effects normally expected with these drugs, such as stroke, heart attack or death.
“While effectiveness and cost are always important factors, patients and physicians must consider all the information on hand when determining the best medication for the effective treatment of AMD,” added Flaxel. “While this study provides important data regarding effectiveness, it should not be considered the only data to guide prescription decisions.”
A grant from the National Eye Institute, a component of the National Institutes of Health, funded this research.
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