Is Avastin better than Lucentis for AMD?

A group of researchers from China have evaluated randomized controlled clinical trials from around the world to study the efficacy and safety of Avastin^tm (bevacizumab) versus Lucentis^tm (ranibizumab) in wet (neovascular) age-related macular degeneration (AMD).

(c) trumedcost.com

The researchers performed a comprehensive literature search using the Cochrane Methodology Register to identify randomized controlled trials (what is a ramdomized controlled trial? Read more here.) comparing bevacizumab with ranibizumab in patients with neovascular age-related macular degeneration. Efficacy was determined by comparing change of best-corrected visual acuity and central macular thickness from the baseline evaluation values. Safety was determined by calculating rates of death, arteriothrombotic events, venous thrombotic events, and at least 1 serious systemic adverse event. 

In this analysis, total of 6 randomized controlled trials were selected for this meta-analysis, which in total included 2,612 patients (1,292 patients in the bevacizumab group and 1,320 patients in the ranibizumab group). There were no significant differences between bevacizumab and ranibizumab in best-corrected visual acuity mean change at 1 year or 2 years. Ranibizumab was found to be more efficacious in reducing central macular thickness at 1 year. When serious systemic adverse events at 1 year and 2 years were compared, the results were slightly in favor of ranibizumab, whereas the rates of death, arteriothrombotic events, and venous thrombotic events did not differ statistically.

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The authors conclude that bevacizumab and ranibizumab have equivalent efficacy for best-corrected visual acuity in the treatment of neovascular age-related macular degeneration, with ranibizumab tending to have a better anatomical outcome. There were no differences between drugs in rates of death, arteriothrombotic events or venous thrombotic events, and differences in rates of serious systemic adverse events that require further study.

Note from the editor: So what is the verdict? Reports so far demonstrate that the two compounds are equally effective and there are no significant safety issues between them. Yet, we need to remember that in spite of the CATT trial conducted by NEI that demonstrated equal efficacy between the two, Avastin continues to be used off-label, while Lucentis is the only FDA approved treatment for AMD between the two. With all medical factors considered, we believe that patients should get the benefit of Lucentis injections for wet AMD. Obviously, patients and family members have to decide between the two based on other logistical issues, such as availability, price and their physician's recommendation.

We recommend you consult your healthcare provider before making a decision. 

Source: Retina

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