There is no doubt that Lucentis has been a blockbuster product worldwide for age-related macular degeneration. One of the mechanisms of wet age-related macular degeneration is an increase in a chemical called vascular endothelial growth factor (VEGF). Lucentis blocks the action of this chemical and hence the beneficial effect of treatment.
VEGF levels are also increased in other retinal disease most notably retinal vein occlusions and diabetic macular oedema. Treatment with Lucentis has been studied in both major types of retinal vein occlusion. These are central retinal vein occlusion and branch retinal vein occlusion. Large studies reported in 2011, the BRAVO (branch vein occlusion) and CRUISE (central vein occlusion) studies. In both these studies patients were treated with monthly lucentis for a period of time and then as needed based on certain criteria.
The results have been very encouraging, just over 60% of patients in the BRAVO study had a meaningful improvement in vision of three lines on a standard vision chart. In the CRUISE study nearly 50% of patients achieved three lines of improvement in their vision. There was approximately double the chance of this level of vision improvement compared to exisiting treatment approaches which included laser or simply observation.
At the time of writing the UK regulatory body NICE is still in the process of evaluating whether this should be funded on the national health service. The initial response so far as with diabetic macular oedema has been negative due to cost-effectiveness concerns. Ozurdex injection remains an alternative option and some patients choose to try for similar results as Lucentis using injections of Avastin. For this disease at present there is no study directly comparing these or a particular combination of these agents. There is little doubt though that eye injection treatments (the specific choice of drug should be discussed with your doctor) are the current best option when considering treatment for this disease.
