Utilizing a treat-and-extend treatment regimen for Avastin (bevacizumab) or Lucentis therapy proved visually efficacious as well as time- and cost-efficient among patients with neovascular AMD, a speaker said at the Macula 2011 meeting.
While visual outcomes and recurrence rates were similar for patients who received Lucentis or Avastin, Avastin therapy cost less, Omesh P. Gupta, MD, said at Macula 2011.
Dr. Gupta presented data from 166 eyes of 159 patients in a retrospective case series comparing visual outcomes, number of injections and medical costs of therapy in patients who received Lucentis or Avastin. Mean follow-up was 1.5 years.
Patients were treatment-naive at the start of therapy and received monthly injections until seen as "dry" on OCT assessment. Treatment intervals were extended by 2 weeks at a time unless exudation was seen on OCT.
Visual outcomes were similar between the two arms of the study. At 1 year, 32% to 35% of patients gained at least three lines. The mean period of extension between the two arms was statistically significant, Dr. Gupta said, with Avastin treatments extending longer.
The treat-and-extend regimen was linked to significantly fewer patient visits, fewer injections and lower medical costs compared to all phase-3 trials (such as MARINA and ANCHOR).
Mean number of injections and overall cost were greater in the Lucentis group, Dr. Gupta said.
"Significant cost savings can be achieved with treating patients with bevacizumab compared to ranibizumab," he said.
WHAT IT MEANS TO YOU: The argument in favor of using Avastin over Lucentis is almost always economic. Because Avastin is much cheaper than Lucentis, patients and their insurance provider can save lots of money by using Avastin. However, the "treat and extend" dosing strategy reveals another potential benefit of Avastin - its longer half-life. There are several studies indicating that Avastin may have a longer duration of action than Lucentis. The treat and extend approach is designed to take maximum advantage of the drug's duration of action by titrating the injections (and office visits) to the longest possible period for each patient. This study finds that, on average, patients on Avastin could go longer between injections than patients on Lucentis.
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