The cancer drug Avastin may work just as effectively as the more expensive Lucentis at treating age-related macular degeneration, new research suggests. But the potential side effects bear watching.
The early results of a clinical trial comparing the two drugs was published online Thursday in the New England Journal of Medicine, slightly ahead of schedule.
Avastin doesn’t have FDA approval to treat AMD -- it’s approved to prevent the growth of blood vessels that fuel tumors. But doctors began using it to treat the “wet” form of age-related macular degeneration, in which abnormal blood vessels begin to grow under the macula and leak blood and fluid, because of its chemical similarity, similar goal and price. Avastin, or bevacizumab, costs about $50 per injection; Lucentis, or ranibizumab, costs about $2,000.
Several studies have suggested the two worked equally well. A study published in the journal Eye in October 2010, for example, found that the two were similar, but the trial only enrolled 22 patients. That was hardly large enough to find side effects.
The current trial -- 1,185 people -- has the numbers to compare the two drugs and find potential side effects.
Researchers from the National Eye Institute divided patients with “wet,” or advanced, AMD into one of four groups: a Lucentis injection once a month; a Lucentis injection as needed; an Avastin injection once a month; or an Avastin injection as needed.
Visual acuity improved for all four groups, and the effects of the drugs were considered equivalent -- with more frequent administration showing generally better results.
But the two drugs might pose slightly different side-effects risks. Serious adverse events, largely hospitalizations, were seen in 24% of Avastin patients compared with 19% of Lucentis patients.
As the researchers noted, many factors could explain the difference in rates, but considering that earlier Avastin studies have suggested potential risks as well, the side-effects issue is one to watch.
The clinical trial still has another year to go.
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