Retina specialists have been using anti-vascular endothelial growth factor (anti-VEGF) drugs to treat wet AMD since 2004's launch of Macugen (pegaptanib, Bausch + Lomb) showed early promise for the drug category. The following year, Philip Rosenfeld, MD, of Bascom Palmer reconstituted the cancer drug Avastin (bevacizumab, Genentech) for ocular use, beating the same company's launch of its own intravitreal anti-VEGF drug Lucentis (ranibizumab, Genentech) to market by a year. Regeneron's Eylea (aflibercept), approved in 2011, extended the treatment interval to eight weeks; just last week, the FDA approved a 12-week dosing schedule for that drug.
Throughout intravitreal anti-VEGF's torrid history , clinical indications have expanded beyond AMD and it's proven itself to be the blockbuster success story of retina care in the last two decades.
In a recently published literature review, researchers performed a meta-analysis to understand the potential safety and efficacy of these therapies. What they found is that these therapies are safe and effective for wet AMD over at least a two-year period. However, the authors recommend close follow up during that time.
The team identified 28 studies worth including, and assigned each one a level of evidence rating. They pinpointed 16 citations of level I evidence supporting the use of Lucentis, Eylea and Avastin. While they also found eight studies that provided level II evidence and four that provided level III evidence, the investigators stuck with the 16 studies that provided level I evidence to make their assessment.1
1. Bakri S, Thorne J, Ho A, et al. Safety and efficacy of anti-vascular endothelial growth factor therapies for neovascular age-related macular degeneration. Ophthalmol. August 21, 2018. [Epub ahead of print].