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Cheaper drug as effective as expensive treatment for AMD patients

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Professor Simon Harding (right). Liverpool was the largest recruiting site for the study and also the supplier of the Avastin doses for the research

Scientists at the Universities of Liverpool, Belfast, Bristol, Southampton and Oxford, have shown that an anti-cancer drug is equally as effective in treating the most common cause of blindness as a more expensive drug specifically formulated for this purpose.

The results from the IVAN research study, published in the Lancet, show that two drug treatments, Lucentis and Avastin, are equally effective in treating neovascular or wet age-related macular degeneration (wet AMD).

Common cause of sight loss

Wet AMD is a common cause of sight loss in older people with at least 23,000 diagnosed with the condition in the UK each year.  Without treatment two thirds of people with this condition will experience severe loss of sight within two years of being diagnosed.

Over the past five years, a team of scientists and eye specialists from 23 UK hospitals and universities have investigated whether Lucentis and Avastin, and the way they are administered, are equally effective and safe.

The NHS could save £84.5 million annually, based on injecting 17,295 eyes each year by switching from Lucentis to Avastin. There has been controversy, however, amongst policy makers about the use of Avastin which is not specifically licensed for wet AMD.

”We found that sight was equally well preserved with either of the two drugs.  Giving the treatment regularly every month resulted in slightly better levels of vision”

Professor Simon Harding, from the University of Liverpool’s Institute of Ageing and Chronic Disease and the St Paul’s Eye Unit at Royal Liverpool University Hospital, said: “Avastin is already used to treat wet AMD in some parts of the UK and extensively elsewhere in the world and also for other eye conditions.

“In our study, which included 610 people with AMD, patients received injections of the drug into the affected eye every month for the first three months.  They were then subdivided to receive the injections each month.

“We found that sight was equally well preserved with either of the two drugs.  Giving the treatment regularly every month resulted in slightly better levels of vision.”

Liverpool was the largest recruiting site for the study and also the supplier of the Avastin doses for the research.

Significant savings

The study, called IVAN, monitored the drugs for serious adverse drug reactions, including death, heart attacks and strokes. These were similar for the two drugs, reducing the previous concern that Avastin

may have a higher rate of stroke or heart attack.

Professor Harding added: “We recommend that the NHS switch from Lucentis to Avastin and make significant savings to be reinvested in patient care.

“Surprisingly our safety findings show that the risk of death for people having continuous treatment is halved and this needs to be discussed with patients.”

The IVAN study is funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme.   The Belfast Health and Social Care Trust sponsored the clinical trial.

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