Update from the 29th Annual Meeting of the Macula Society

Most of the world’s experts in macular disease belong to The Macula Society. We just had our annual meeting in North San Diego. I thought it was an excellent meeting and here are some of the highlights:

Lucentis®

The trials involving Lucentis® continue to show excellent results that are much better than treatment with either Visudyne® (PDT), or Macugen®. A re-analysis of the data from the MARINA Study, which compared treatment with Lucentis® to a sham treatment, revealed that Lucentis® was very effective for the treatment of wet AMD no matter what the age of the patient, the size of the new blood vessels, the type of new blood vessels, or the initial visual acuity.
Results from the ANCHOR Study showed that the visual acuity was significantly better in the groups of patients treated with Lucentis® compared to the group treated with Visudyne®. The neovascular membranes continued to enlarge in the Visudyne® (PDT) group during the first year of treatment whereas they pretty much stayed the same size in the Lucentis® group.

Avastin®

Avastin® is the parent molecule of Lucentis®. Since Lucentis® is not yet FDA approved, many retinal specialists are injecting Avastin® into the eye instead. There were four papers on the use of intravitreal Avastin®. All four had very positive results which appeared similar to those with Lucentis® although these patients have been followed for only three to six months. The only ocular complication in the total of 570 patients in these four reports was mild inflammation in the vitreous in three patients which cleared on its own.

So What Now?

This may be controversial, but I’m not going to treat any new patient with Macugen®. I’ll use Avastin® instead or ask the patient if he or she would be interested in participating in a clinical trial testing Lucentis®. If my mother were alive and had wet AMD, I’d tell her the same thing. I asked five or six colleagues at the meeting and they agreed with me although two of them had not yet totally given up on Macugen®. If a follow-up patient appears to be doing well with Macugen®, I’ll continue to inject them with that drug. If they aren’t doing well, (the vision is worse, there’s still fluid in the retina or the neovascularization is growing), then I’ll switch to Avastin®.

Coming up later this week:

Safety of Avastin® and Lucentis®
Challenges ahead
More on AMD from the Macular Society Meeting

And again, my family and I have no stock in the companies that make Visudyne®, Macugen®, and Avastin® and Lucentis® nor am I paid by any of these companies. Please e-mail with any questions.
Thanks,
JCF