A major study has found Avastin is as effective as Lucentis in the treatment of wet age-related macular degeneration (AMD).
Findings from the much-anticipated IVAN study were reported at the Association for Research in Vision and Ophthalmology (ARVO) conference in Fort Lauderdale, Florida, last Sunday (May 6).
The IVAN, or Inhibition of VEGF in Age-related Choroidal Neovascularisation, study was one of the largest ever carried out in the field of eye disease in the UK, trialling 610 people with wet AMD. Full results will be published in the journal Ophthalmology.
One-year findings showed no functional difference in the effects of both drugs and found their effects on preventing vision loss were similar.
The study also indicated that the NHS could save £84.5m annually, based on injecting 17,295 eyes each year, by switching from Lucentis to Avastin, and administering the treatment on an as-needed basis.
Professor Usha Chakravarthy of Queen's University Belfast, who led the research study team, said: 'The IVAN results at the end of the first year show that Lucentis and Avastin have similar effectiveness. Regardless of the drug received, or treating monthly or as needed, sight in the affected eye improved by between one and two lines on a standard eye test.'
Results complemented the one-year findings of a sister study, the Comparison of Age-related Macular Degeneration Treatments Trials (CATT), performed in the US.
With respect to possible adverse effects of the drugs, in IVAN a slightly higher rate of arteriothromboembolic events [mainly heart attacks and strokes] or heart failure was observed among people treated with Lucentis compared with Avastin, which was not observed in CATT. But when the results of the two trials were combined no difference in heart attacks or strokes was observed between the two drugs.
Both studies showed no difference in mortality between the groups receiving different drugs in the elderly study populations, but found a slightly higher rate of other serious adverse events in those who received Avastin. Researchers suggested this was unlikely to be due to Avastin directly, but that events were more common in patients treated less frequently and of causes not previously associated with either drug.
Macular Disease Society chief executive Helen Jackman welcomed the results but said they did not provide definitive safety information. 'The overall question of the safety of Avastin is, unfortunately, not answered to everyone's satisfaction by these trials. The use of Avastin will remain a matter of judgment for clinicians with some satisfied with the evidence and others not,' she added.
Lucentis manufacturer Novartis said: 'Although the IVAN trial will help contribute to the existing data for treating wet AMD, it is unable to fully answer questions around the efficacy and safety of unlicensed intravitreal bevacizumab for use in the eye. IVAN is not designed to the same standard as trials which are used to make regulatory decisions.'