CORRECTION: Lucentis effective for common cause of blindness

[Corrects story posted Oct 4, 2006. A portion of the first sentence was deleted in earlier version.]

NEW YORK (Reuters Health) - Monthly eye injections with Lucentis (ranibizumab), an antibody designed to bind to and inhibit a protein that plays a role in the formation of new blood vessels, can help prevent vision loss from "wet" age-related macular degeneration (AMD), a common cause of blindness in older adults. Moreover, this treatment appears to be superior to verteporfin therapy, which combines drug and light therapy.

The findings stem from two studies appearing in The New England Journal of Medicine.

AMD is the number one cause of blindness among adults over 50 years of age in the US. However, 90 percent of the cases are due to a "dry" form of the disease. Wet AMD, which accounts for the remaining cases, involves abnormal blood vessel formation, which results in fluid leakage that damages the vision cells in the eye.

Lucentis was approved by the US Food and Drug Administration in June as a treatment for wet AMD, also known as neovascular AMD.

In the MARINA study, Dr. Philip J. Rosenfeld, from the University of Miami, and colleagues assessed the vision of 716 patients who had been randomly assigned to monthly injections of Lucentis (at a high or low dose) or placebo injections for 2 years. All of the patients had relatively early-stage disease.

At 1 year, roughly 95 percent of patients treated with either dose of Lucentis had no loss of vision compared with 62 percent of comparison subjects. Moreover, 25 percent of patients treated with low-dose Lucentis and 34 percent treated with the high dose experienced an improvement in vision, compared with just 5 percent of comparison subjects.

These benefits were still apparent after 2 years.

Inner eye inflammation, which can signal a serious infection, developed in about 1 percent of patients treated with Lucentis compared with 0 percent of comparison subjects.

Meanwhile, in the ANCHOR study, Dr. David M. Brown, from the Methodist Hospital in Houston, and colleagues compared the outcomes of 423 patients who were treated with Lucentis or with verteporfin therapy for 1 year.

About 95 percent of Lucentis-treated subjects lost no vision compared with 64 percent of verteporfin-treated patients at 1-year follow-up. In addition, vision improved in 36 to 40 percent of Lucentis-treated patients compared with 6 percent of those given verteporfin.

Once again, inner eye inflammation developed in about 1 percent of patients treated with Lucentis.

Both MARINA and ANCHOR were supported by Lucentis-maker Genentech and Novartis Pharma.

In a related editorial, Dr. Edwin M. Stone, from University of Iowa in Iowa City, comments that before Lucentis became available, many doctors were using bevacizumab, an antibody therapy originally approved for advanced colon cancer. Early reports suggested that this agent, which is much less expensive than Lucentis, is safe and effective for wet AMD.

"A head-to-head study of Lucentis and bevacizumab and a careful evaluation of an 'induction and follow-up' strategy with either drug are probably the next most useful steps in this field," Stone concludes.

SOURCE: The New England Journal of Medicine, October 5, 2006.