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New Eye Drugs Treat Macular Degeneration

Doctors Explore Variety of Options to Fight Vision Loss

WebMD Health News

Oct. 17, 2005 (Chicago) -- Some ophthalmologists are treating an increasing number of people at risk for severe vision loss from age-related macular degeneration with a drug approved for cancer. And others are expressing optimism about the promise of new drugs now available or in the approval process.

"It's an exciting time," says Larry Singerman, MD, of the Wills Eye Institute in Philadelphia. "Tremendous progress is being made in what would otherwise be an epidemic of age-related macular degeneration."

Age-related macular degeneration is the leading cause of irreversible and severe vision loss in people over the age of 55. It occurs when the central vision becomes blurred; there is a loss of straight-ahead vision needed for activities like reading, sewing, and driving.

It has been estimated that 1.7 million Americans have advanced age-related macular degeneration. The condition develops when new blood vessels grow and invade the region of the eye that contains the nerves that transmit vision. These new vessels are often leaky and lead to bleeding within this region, causing loss of central vision.

About 200,000 new cases of age-related macular degeneration are diagnosed each year as the baby boomer generation ages.

New Treatments

Now new treatments that are injected into the eye and bind to a blood vessel growth factor -- known as vascular endothelial growth factor (VEGF) -- are making headway in the treatment of this disease.

Singerman described the success of Macugen, a relatively new drug on the market. The drug binds to VEGF, thereby inhibiting the growth of new blood vessels in the eye.

However, some doctors are using Avastin, which was originally approved by the FDA for the treatment of people with metastatic colorectal cancer. Avastin also inhibits the growth of new blood vessels.

Drugs in the Pipeline

Doctors are awaiting another new drug by the same manufacturer to hit the market, said Peter Kaiser, MD, during a news conference at the American Academy of Ophthalmology Annual Meeting here. Kaiser is director of research at the Cole Eye Institute of The Cleveland Clinic.

Kaiser said Lucentis looks promising.

Administered with monthly injections to the eye, the results have been phenomenal, he said, with 40% of patients with advanced disease achieving at least 20/40 vision. "This takes a patient who can't drive and allows them to drive."

Kaiser said Avastin appears to work in a similar way to Lucentis but has not had the same safety and effectiveness studies performed. "Theoretically it should work," he said. "The problem with Avastin is we don't know the safety."

High Costs

Avastin is much less expensive, Kaiser said. Treatment with Lucentis injections is expected to range from $12,000 to $16,000 a year when it hits the market, while Avastin is $1,400 a year.

"Physicians are not injecting it because it is cheaper, but because it's the only thing available," he said. "A lot of retinal specialists are using it. There are desperate patients who are failing other therapies and physicians are trying it."

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