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Avastin and Lucentis Equally Effective for Macular Degeneration

Human eye

People who have macular degeneration can likely expect equal results from Avastin (bevacizumab) and Lucentis (ranibizumab), but the big difference is in the cost. While Lucentis costs about $2,000 per injection, Avastin comes in at a mere $50 per injection.

Injections equally effective for treating macular degeneration

Avastin and Lucentis both treat the same form of macular degeneration, but only Lucentis has approval from the Food and Drug Administration (FDA) for this disease. Avastin has FDA approval for another completely different disease, colorectal cancer, but doctors around the world have been recruiting bevacizumab for off-label use to treat wet macular degeneration because it is effective.

The recently released results from researchers at Boston University School of Medicine and the VA Boston Healthcare System represent the final outcome of the prospective, double-blind, randomized clinical trial that directly compared bevacizumab to ranibizuamab. Six months ago investigators released preliminary outcomes from the same study, and at that time they reported no difference in efficacy between the two drugs.

According to the American Macular Degeneration Foundation, this incurable eye disease affects more Americans than glaucoma and cataracts combined. It is the leading cause of blindness among people aged 55 and older in the United States, and currently it affects more than 10 million Americans.

Of the two types of macular degeneration—dry and wet—the wet type affects 10 to 15 percent of those with the disease, yet it is the more serious of the two. This is the form of the disease being treated by Avastin and Lucentis.

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Wet macular degeneration is characterized by abnormal blood vessels that grow under the retina and macula, which is located at the center of the retina. These new blood vessels can bleed and leak fluid, leading to destruction of the macula, which is responsible for central vision. Vision loss can be rapid and severe.

Dry macular degeneration does not involve any leakage of blood or serum, although patients experience vision loss associated with the formation of deposits called drusen. These yellow deposits accumulate under the macula and causes it to lose its function.

In the study, patients received were given injections of either Avastin (15 patients) or Lucentis (7 patients) every month for the first three months of the study. They were then examined and tested on a monthly basis and received further injections as needed for one year. Patients in the Avastin group received an average of eight injections over one year compared with an average of four injections in the Lucentis group. In terms of cost, the average to treat patients with Avastin was $400 compared with $8,000 for those receiving Lucentis.

Patients in both groups had similar visual acuity and anatomic outcomes, with an average improvement in vision of 1.5 lines on the testing chart. One patient in the Lucentis group experience significant vision loss, while none in the Avastin group did.

Manju Subramanian, MD, assistant professor in ophthalmology at Boston University School of Medicine and the lead author and principal investigator on the study, noted that except for the fact that patients who received Avastin required more injections, “visual and anatomic outcomes at one year failed to show a significant difference between both groups.” Therefore Avastin and Lucentis are equally effective in treating macular degeneration, but their impact on the wallet is significantly different.

American Macular Degeneration Foundation
Boston University School of Medicine