Anti-VEGF Medications for Wet Macular Degeneration Treatment and other Eye Diseases
Wet macular degeneration (AMD) treatment often involves intro-ocular or eye injections using anti-VEGF medications. VEGF stands for vascular endothelial growth factor. VEGF is a protein that the body makes that promotes blood vessel growth. Another term for new blood vessel growth is angiogenesis. Wet AMD is aptly named because the macula – a very small spot in the center of the retina – gets “wet” as a result of these new, but abnormal vessels that leak blood and fluid. The goal of wet macular degeneration treatment is to “dry up” this area in the retina that is responsible for our detailed and straight ahead vision. Another goal of wet AMD treatment is to prevent the new growth of these abnormal and fragile vessels.
This fairly new class of drugs, called anti-VEGF medications, is given as injections directly into the eye to help shrink existing abnormal blood vessels and to prevent the growth of new leaky blood vessels. There are four different medications that are used to treat wet macular degeneration. They are Macugen, Lucentis, Avastin and the most recent one is Eylea.
In 2006 Lucentis (ranibizumab) was FDA approved after several clinical trials. These monthly eye injections were shown to help maintain vision at 12 months in almost 95% of the participants in the three multicentered, randomized studies. Sixty percent of patients who received the control treatment maintained their vision in the same time frame.
Avastin is also an anti-VEGF therapy that was originally approved for use – not in patients with wet macular degeneration – but for patients who had colon cancer. Cancer tumors also develop new blood vessels that feed the tumor and cause it to grow. Anti-VEGF treatment prevents the growth of these blood vessels causing the cancer to “starve.” What made this medication so appealing compared to Lucentis is the dramatic difference in cost. Avastin is moleculerly very similar to Lucentis, so physicians were administering Avastin to patients with wet macular degeneration in what is called off-label use. As a result there are clinical trials comparing Lucentis to Avastin in the treatment of wet macular degeneration show they are comparable in effectiveness.
The PBS subsidises use of Eylea and Lucentis for a certain types of eye diseases. There are however many instances where anti-VEGF therapy may save sight but are not covered my the PBS. In these instance Avastin is a much cheaper option.
Eylea is the most recent anti-VEGF therapy on the market at the time of this writing. The benefit to this eye medication is that it can be given less frequently. Less visits to the eye doctor and less eye injections are very appealing to most patients.