Much cheaper drug proved as well as a sum of $2,000 monthly turned to the treatment of common eye disorder which can lead to blindness, a highly anticipated study has found. It also shows that patients may be treated less often, saving them lots of pain and expense.
The results are expected to lead many physicians and patients to walk away from the more expensive Lucentis and use rather blows $ 50 of Avastin for age-related condition called wet macular degeneration.
Improvement of vision after a year was the same for those given Avastin or Lucentis, 1 200-patient study.
The results are a blow to the Genentech from Roche unit, which sells the two drugs. AVASTIN (ah-VAS-Tin) is a cancer drug that doctors have used for many years to treat the disease of the eyes, even if it is not approved for this purpose. Genentech had developed Lucentis (loo-SEN-tis) specifically for eye disease and won approval for it in 2006. A spokesman for the company, said Thursday that the company did not intend to seek approval to sell Avastin for use of the eye or to lower the price of Lucentis.
Yet, the results are a boon for patients and insurers - especially Medicare - because nothing prevents the use of Avastin cheaper, said of the eye specialists. Doctors who use it for the eye disease require a pharmacist to prepare smaller doses instead of the intravenous injection, it is used for cancer.
"It is always good news for patients when there is more than one option for a condition." This is good news for the country. "Now we have potential for significant savings at a time where the cost of health care is mounted sharply,", said Dr. Paul Sternberg, President of the Vanderbilt Eye Institute.
He had no role in the study, whose results were published online Thursday by the New England Journal of Medicine and will be presented at a Conference of research eye Sunday.
Any person wishing to use Lucentis now will have to justify its cost for insurers and policymakers, Dr. Philip Rosenfeld of Bascom Palmer Eye Institute at the University of Miami wrote in an editorial with the study. Has no connection with Genentech, he consulted for several other companies developing treatments of the eye.
Macular degeneration are treated more than 250,000 Americans each year, especially with Avastin, said Dr. Paul Sieving, Director of the National Institute of the eye, the Federal Agency who has paid for the study. Approximately 1.6 million Americans have advanced macular degeneration and another 7 million are at risk of developing it, he said.
The disease occurs when the abnormal vessel growth blood damages the part of the retina responsible for central vision. AVASTIN and Lucentis aim to a protein that stimulates the growth of blood vessels. They are injected through the white part of the eye into the central cavity. Numbing drops are used and patients usually feel the pressure more pain, Sternberg said.
"The first time that you tell a patient they will have to receive one, they are taken aback and apprehension, but they are remarkably tolerated," he said shots.
In the study, patients received one of four treatments a year: Avastin or Lucentis every four weeks, or two drugs based need according to the response. Those on "need" dosage required four to five shots less than a year as the others.
Improvement of vision was almost identical for each drug. Give two drugs less often produces a little less improvement in vision - two letters less on a graph of the vision of reading something a researcher to a finger on his glasses.
"This is a very small difference," said screening of the Federal Institute of the eyes.
Maureen Maguire at the University of Pennsylvania study leader agreed.
The gift of each drug to the need "is certainly a viable option" that many older patients in spare parts the burden of monthly hits, said.
Undesirable, especially hospitalization, were more frequent among users of Avastin, but many of them were side effects are not thought to be drug-related, and the study is too small to give a clear picture on these.
"We have seen more undesirable when we gave less drug," and don't know what that means, that study co-leader Dr Daniel Martin Cole Eye Institute of the Cleveland Clinic.
No great difference were seen in large problems such as heart attacks, strokes and deaths.
In a statement, said Genentech that prove the benefit of Avastin for the eye disease would take "substantial resources and years of clinical development," and that the interest of patients is better served by exploring new drugs.
"We believe that Lucentis is the most appropriate treatment," because it was designed specifically for use in the eyes, said the Chief of ophthalmology at Genentech, Dr. Anthony Adamis.
Although Genentech sells the two drugs, PDL BioPharma Inc. Gets the payment of royalties on Lucentis and Novartis AG has the exclusive rights on it outside the United States.
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Online:
Journal: http://www.nejm.org
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