RCOphth Review concludes that Avastin and Lucentis are equally effective in treating wet AMD
The Royal College of Ophthalmologists has today (Wednesday, 14 December 2011) released the conclusions of a working group of leading experts who reviewed the published scientific literature to assess the efficacy of ranibizumab (Lucentis) and bevacizumab (Avastin) in the treatment of Age Related Macular Degeneration (AMD) 1.
The following was taken from the College website;
The two drugs are anti-VEGF2 agents and the working group concluded that both are equally effective in the treatment of AMD and have a similar safety profile.
The use of Avastin instead of Lucentis would save the NHS considerable sums of money but when Avastin is used for the treatment of eye disease it is used “off-label”. Current General Medical Council (GMC) guidance states that doctors who prescribe off-label must be satisfied that doing so would better serve the patient’s needs than using an appropriately licensed alternative. There is no evidence that Avastin is more effective than Lucentis for the treatment of AMD.
The College supports the continued use of Lucentis rather than Avastin for patients with wet AMD who fall within the National Institute for Health and Clinical Excellence (NICE) guidelines for treatment. Primary Care Trusts are legally obliged to fund NHS treatment with Lucentis if an ophthalmologist prescribes it.
The College believes that the NHS executive should urgently instruct NICE and the Medicines and Healthcare Products Regulatory Agency (MHRA) to evaluate the use of Avastin in the treatment of AMD and produce National Guidelines for the use of anti-VEGF agents in AMD.
Ophthalmologists should have the discretion to use Avastin rather than Lucentis for the treatment of AMD if it is in the patient’s best interest to do so and provided the patient gives informed consent. This may occur, for example, when an ophthalmologist wishes to use an anti-VEGF agent earlier than specified in the NICE guidelines or when the patient has failed to respond to Lucentis.
The College supports the use of Avastin for medical retina conditions for which no licensed or NICE approved alternative medicine is available. The ophthalmologist must source the Avastin from a reputable pharmacy. The key issue is that the patient must be provided with full information about treatment alternatives and must give informed consent.
