Anti-VEGF dugs may slow age-related macular degeneration, study shows

(Bethesda, MD – Insurance News and Markets) – The National Institutes of Health recently announced the publication of a study looking at treatment with anti-VEGF drugs for more than 600individuals who had age-related macular degeneration, or AMD.  With five years of treatment with anti-VEGF drugs, half of those in the study still had20/40 vision, or better. This is typically good enough to drive or read standard print. The results of the study were published in the journal Ophthalmology. Researchers presented the information in May at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO) in Seattle.

“This is the most comprehensive study of anti-VEGF therapy for AMD to date,” said NEI Director Paul A. Sieving, M.D., Ph.D. “It points to the importance of long-term follow-up in studies evaluating disease treatments.”

The new study looked at people with AMD who had regular treatment with drugs designed to block VEGF. After five years, 50 percent of them had 20/40 vision or better, 20 percent had 20/200 vision or worse, and the rest were in-between.

AMD damages the central area of the retina, which senses light. There aren’t always symptoms in the early stages, but later, individuals with AMD may lose the central, straight-ahead vision that is important for reading, driving and other activities.

There are two types of late AMD — geographic atrophy, and the more common neovascular AMD, also known as wet AMD. In wet AMD, fragile blood vessels grow under the retina and leak fluid. This usually starts in one eye, and is stimulated by a protein called VEGF. A decade ago, people diagnosed with neovascular AMD were almost certain to develop severe vision loss in their affected eye and likely the other eye.

The best treatment for AMD ten years ago involved injecting a drug into a vein and sealing off leaking blood vessels with lasers. A year after this treatment, fewer than 15 percent of patients treated this way have retained 20/40 vision, and almost 40 percent have 20/200 vision. .

The Comparison of AMD Treatment Trials, or CATT, started in 2008, comparing Avastin and Lucentis. More than 1,200 individuals with wet AMD were chosen randomly to receive treatment with one of those drugs for two years, either monthly, or as needed.

The current study looked at how those participants had fared, about 5.5 years after the trial start. After two years on their assigned drug, participants were free to work with their eye care providers to choose their own course of therapy. During that 3.5-year period, more than half received at least one treatment with a drug or therapy other than the drug assigned to them.

In addition to the overall effects of anti-VEGF therapy at five years, the investigators compared the outcomes of participants who received Avastin or Lucentis during the trial.

“Some experts had speculated that two years of treatment with ranibizumab might have long-term benefits superior to bevacizumab. However, at five years, there were no differences in visual acuity between the two drugs,” said Daniel F. Martin, M.D., chair of the Cleveland Clinic Cole Eye Institute and CATT study chair.

Source: National Institutes of Health.