macular degeneration
Wet AMD Lucentis
Lucentis ® (Ranibizumab) Anti VEGF Therapy.
Research has identified a molecule that plays a pivotal role in the growth of abnormal blood vessels inside the eye. This molecule is called 'vascular endothelial growth factor' or VEGF and in addition to promoting new vessel growth it also has the ability to make otherwise healthy retinal blood vessels very "leaky" thus leading to retinal swelling (macular oedema). Such changes, brought about by high levels of VEGF can be halted or reversed by blocking the action of VEGF.
Lucentis is an antibody fragment that inactivates all active forms of VEGF. Lucentis has the benefit of a rigorous and exhaustive research database to support its use in Wet AMD. Lucentis has passed through United States Phase I, II and III trials with excellent safety data and astounding visual results.
The M.A.R.I.N.A study was a clinical trial that showed 95% of patients with Wet AMD receiving four weekly Lucentis injections experienced visual stability. Up to 40% of Lucentis treated patients actually showed vision improvement amounting to a doubling of the resolution of the eye. For comparison, previous therapies including Photodynamic therapy for Wet AMD usually show such levels of vision improvement occurring in around 5% of patients! This gives an indication of the real quantum leap in therapy for Wet AMD that Lucentis represents.
Safety data from the M.A.R.I.N.A study showed infection occurring in around 0.6% of patients after twelve months of therapy. There are ongoing studies investigating the effectiveness of using a lower frequency of drug administration, one injection per four weeks followed by an injection every three months thereafter until final stabilisation. The results of this less intensive therapeutic approach for Lucentis are likely to be published shortly. Until this data is available it is reasonable to undergo injections on a four weekly basis for at least six months before considering the reduced frequency. It may also be possible to combine the Lucentis injections with Photodynamic therapy to try and achieve a more rapid stabilisation of the Wet AMD and to limit the overall duration of the treatment program.
Results
