Both Approved and Non-Approved AMD Drugs Work Equally Well

AMD (age-related macular degeneration) is the leading cause of blindness over the age 50 in the USA.  The gold standard treatment for wet AMD – the type with the highest risk of blindness – is an antibody against VEGF-A, a protein that promotes the development of new blood vessels; it’s called Lucentis® (ranibizumab), and it’s made by Genentech.  This drug company also makes an anti-cancer drug, Avastin® (bevacizumab), which is also an antibody against VEGF-A.  Lucentis is approved for use in AMD, and costs about $2,000 per injection, whereas Avastin is not approved for this use, and costs about $40 per injection; however, many physicians have used the cheaper Avastin and found that it works equally well.

To help substantiate these reports, Boston-based researchers have conducted a small double-masked clinical trial of the two substances, evaluating effectiveness and safety.  (Double-masked is the same as double-blind, where ‘blind’ is not an appropriate word to use in eye studies.  A double-blind or double-masked study is one in which neither the participants nor the study staff know which participants are receiving which experimental treatment.)  The results are reported in the American Journal of Ophthalmology. 

Twenty patients completed the 6-month follow-up.  They had taken either Avastin (13 patients) or Lucentis (7 patients), every month for the first 3 months.  There was no difference in efficacy between the two treatments.  A small study of this size is inadequate to provide significant evidence of ‘no difference’ – something that is always hard to prove – but the results are reassuring to those patients who have been offered, and accepted, the much cheaper but non-FDA-approved drug for this use.