Update on Avastin® vs Lucentis®
I thought that Lucentis would be a little better than Avastin for treating wet AMD. I thought this because Lucentis is a smaller molecule and has a higher binding affinity for VEGF. I’ve used both drugs many, many times for wet AMD and I can’t really tell a difference between them. That’s why we need to do the Comparisons of AMD Treatments Trial (CATT) which will compare Avastin to Lucentis. With the latest worry that Lucentis may increase the risk of stroke, the CATT becomes doubly important. Now we not only want to find out if one of the drugs works better but also if one has a lower risk of side-effects.
I read recently that one expert on the treatment of AMD was quoted as saying that he thought that Lucentis lasted about long as Avastin. I disagree with this. I think that patients who need repeated injections will often start to develop fluid again at four weeks after a Lucentis injection. These patients won’t need repeated injections of Avastin however, for six or seven weeks. I think, on average, and there is a lot of variability among different patients, that Avastin last two weeks longer than Lucentis.
I read recently that one expert on the treatment of AMD was quoted as saying that he thought that Lucentis lasted about long as Avastin. I disagree with this. I think that patients who need repeated injections will often start to develop fluid again at four weeks after a Lucentis injection. These patients won’t need repeated injections of Avastin however, for six or seven weeks. I think, on average, and there is a lot of variability among different patients, that Avastin last two weeks longer than Lucentis.
posted by James C. Folk, M.D. at 12:11 PM
6 Comments:
Dr. Folk,
At the start of the Lucentis trials and toward the end of those trials. The hope and information being sent out, was, that it wold take approximately 3-5 injections with in a year to dry an eye out. However it appears that in many cases their is a need for 12-24 injections.
To me that is quite a significant difference in number.
It relays to me that Lucentis is not doing what it was hoped to do.
Your saying here that there seems to be less injections over a years period with Avastin. I would suggest that the optho community ban together to have Avastin pushed for FDA approval, In the mean time,the offer of Avastin should continue to be given to patients who desire it as an alternative. In addition,Perhaps RS docs should cut down on their use of Lucentis and hit genentech were it hurts~ their pocketbook. When the cash flo decreases, the interest of an official study between Avastin and Lucentis might surface.
Mar.
I am totally confused now. I have received three injections of Lucentis but first two Visudyne treatments. I have a center of my vision missing from the second Visudyne which I would not recommend. The Lucentis has seemed to stop the advancement totally of my myopic degeneration. I go back to my Doctor this month but I am not sure what to ask for now with the stroke risks at age 54.
I have had the exact treatment and result as anonymous. I had two visudyne - the second left a hole in my visionl I had three Lucentis with good results for six months. Vision started to get wavy again and I had a fourth Lucentis this week. I am just 55 but owrried aboout stroke. During injection my blood pressure shot up and my pulse was high and I turned hot pink?"
I work for a large Retinal practice and we probably average 100-200 injections a week. We do more Avastin injections than we do Lucentis. From the testing we do at each visit I would believe that Avastin is a better choice for patients. We see more patients recover some of their sight with Avastin. I know if I were the patient I would choose Avastin!
I work for a retina practice as well, we ONLY use avastin, lucentis is a rip off and its only one arm of the "y' molecule. Avastin works for everything, CME, DME, BRVO, CRVO, CNV. we only do about 200 per month but have a 97% + success rate. MD's are also getting a 6% kickback from Genentech/Roche for using Lucentis and thats about an extra $150 per injection. Lucentis is only approved for wet AMD. Avastin is approved for all mentioned above from almost all insurances, medicare, blue cross, aetna, humana, we rarely have to writ appeal letters for the avastin treatment and alot of our patient need 2 injections per month depending on OCT, FA/ICG. we see many lucentis failures and treat them with avastin and it works like a charm its the drug of the 21st century. oh and p.s. visudyne is about 4 years outdated anyone who is still practicing this is wasting the patient's time. weve been using avastin since november 05' of course with an "off label" consent form.
I disagree that Avastin lasts longer than Lucintis. I have been gettin Avastin injections about every 5-7 weeks. I was given an injection of Lucintis and it lasted almost 12 weeks. I would love to participate in a study of Avastin vs Lucentis. If anyone knows of one, count me in.
solonman@aol.com
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