Health policy makers have been alerted to new findings that cancer drug Avastin (bevacizumab) has similar side-effects to the more expensive and commonly used eye treatment Lucentis (ranibizumab).
A study published this week by The Cochrane Library journal found Avastin does not appear to increase deaths or serious side-effects compared with Lucentis in people with neovascular age-related macular degeneration (AMD).
The review noted that Avastin had been developed to treat cancer while Lucentis was marketed specifically for AMD.
Authors concluded that health policies that favoured the more costly Lucentis instead of Avastin for macular degeneration for reasons of safety were not supported by current randomised controlled trial evidence.
A larger Cochrane Review, to assess additional sources of evidence, was now planned to help reduce the remaining uncertainties around the relative benefits and safety of the drugs.
Although the beneficial effects of the two drugs were believed to be similar, only Lucentis has been licensed as a treatment for macular degeneration, while Avastin was currently approved only as a cancer therapy. Despite this, an unlicensed preparation of Avastin was said to be often used off-label as treatment for macular degeneration, because it was cheaper.
Dr David Tovey, editor in chief of The Cochrane Library, said: ‘This review addresses a question of immense importance to health systems in many countries. One of the many considerations in decision-making at policy level is not just understanding how effective treatments are, but also weighing up evidence of their safety.’
The review included nine randomised controlled trials, none of which were supported by manufacturers of either treatment, involving a total of 3,665 participants who took the drugs over two years.