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Study shows two medications that combat age-related blindness are similarly effective despite significant 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 are published this week in 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 Christina Flaxel, M.D., a physician-researcher at the OHSU Casey Eye Institute and a 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."

Rates of serious side effects one would expect from this class of drugs, such as stroke and heart attack, were similar for patients who received either drug. There was a somewhat higher rate of non-specific side effects, however, in patients receiving Avastin (40 percent), versus those receiving Lucentis (32 percent). Because more events occurred in the patient group that received less rather than more Avastin, the significance of this finding is unclear.

"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.

About Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is an eye disorder associated with aging and results in damaging sharp and central vision. Central vision is needed for seeing objects clearly and for common daily tasks such as reading and driving. AMD affects the macula, the central part the retina that allows the eye to see fine details. There are two forms of AMD, wet and dry. (Source: Center for Disease Control and Prevention)

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