Avastin, Lucentis and Eylea Injections
There is new hope for many who once faced certain blindness due to macular degeneration. Three drugs: Avastin, Lucentis and Eylea are stopping the progression of macular degeneration and in many cases restoring some lost vision. The results of these newer injectable treatments are much better than previous treatments, but patients do need to stick with the monthly injection regimen to obtain and sustain maximum results.
Avastin and Lucentis
The anti-VEGF (anti-Vascular Endothelial Growth Factor) era has provided retina specialists the ability to offer wet AMD (Age-related Macular Degeneration) patients improved vision. Ranibizumab (Lucentis) is a small anti-VEGF antibody and the findings 25% to 40% visual improvement and >90% visual stabilization. Bevacizumab (Avastin) is practically identical to Lucentis. The only difference being the molecules are larger in size than those in Lucentis. Avastin has not been FDA approved for use to treat wet AMD, but it has been FDA approved to treat colon and rectal cancers. Many ophthalmologists, including those at Regional Retinal Consultants have chosen to use Avastin for the off label use to treat wet AMD. The reasoning is the significant cost difference between the two. Although both drugs are manufactured by the same company, Genentech, and are anatomically the same, Avastin costs about $50.00 a dose, while Lucentis costs approximately $2,000.00 per dose. Considering that both drugs require multiple treatments, the cost differential is substantial.
Both Avastin and Lucentis are covered by Medicare, but the terms of coverage can become complicated as well. Lucentis is preferred by most retinal surgeons as the molecules are smaller and easily penetrate the eye's retina. This halts abnormal blood vessel growth contributing to advanced macular degeneration and scarring that causes blindness. Yet most doctors recommend monthly injections, not all injections may be covered by insurance. Avastin is a very effective alternative to those with limited or no medical insurance to get the treatment they need to save their vision.
Avastin and Lucentis have caused much controversy in the medical field, and more clinical debate, testing and FDA trials are sure to be in the future.
Eylea
The FDA has recently approved Eylea for the treatment of the wet form of age related macular degeneration (AMD). In June 2011, an FDA advisory panel unanimously recommended approval of Eylea, previously called VEGF Trap-Eye. The generic name for Eylea is aflibercept.
The blood vessels can leak blood and fluid, causing damage to the retina. Eylea blocks all forms of this factor, called VEGF, and also blocks a second similar factor.
Eylea is also slightly less expensive, at $1,850 an injection versus $1,950 for Lucentis. Eylea is marketed by Regeneron Pharmaceuticals Inc., and states that Eylea can save the health care system thousands of dollars a year per patient, factoring in the fewer injections and also fewer doctor visits and examinations.
Although the FDA has ruled that Eylea's benefits outweigh its risks, the drug can cause some serious side effects:
- Bleeding in the white part of the eye at the site of injection
- Eye pain
- Cataracts
- Vitreous detachment,
- Floaters,
- Increased pressure within the eye
