Off-Label Avastin for Macular Degeneration – An Update

The use of Avastin to treat eye disease such as macular degeneration has increased despite being originally designed for treating cancer. While many proponents have indicated that the use of Avastin was safe, the drug manufacturer Genentech indicated that AVastin was not designed for use in the eye and FDA approval was only for treating certain cancers. Even though the off-label use of Avastin was common, many experts were cautious in stating that this drug was safe for use in the eye and should not be used as a macular degeneration treatment.

Several studies have now added some fuel to fire regarding the safety of Avastin, and the effects of using this anti-VEGF to treat eye disease are having on patients diagnosed with macular degeneration.

In one retrospective study of all patients receiving intraocular injections of Avastin (bevacizumab) at one medical centre between November 2005 and July 2006 found that retinal pigment epithelial (RPE) tears was the most common adverse condition that resulted from the injections of Avastin in patients with preexisting RPE detachments.

Other adverse conditions that were rare included retinal ischemia, subretinal hemorrhage, vitreous hemorrhage, ocular irritation or pain, worsened hypertension and headache. No deaths or blot clotting events were observed from the use of Avastin.

Another study showed that symptoms resembling endophthalmitis developed 1 day after the seventh injection of Avastin in a 76-year-old woman. The woman had extrafoveal occult chorodial neovascularization in conjuction with macular degeneration prior to receiving the injections of Avastin. This condition resolved within 5 days when the patient was treated with corticosteroids. Treatment for macular degeneration continued with macugen and no further irritation occurred.

The risk of infectious endophthalmitis resulting from intravitreal injections of Avastin is considered a small risk due to the introduction of microorganisms into the eye.

Another study provided evidence that AVastin rapidly penetrates the retina of monkeys

Genentech developed Lucentis because its scientists were concerned about how well Avastin would penetrate the retina because of its large molecule size. However, this new study shows that this may not be the case and that Avastin can penetrate the retina.

For more information on these studies you may visit the following websites:

http://www.retinajournal.com/pt/re/retina/abstract.00006982-200809000-00018.htm
http://www.ncbi.nlm.nih.gov/pubmed/18781309?dopt=Abstract
http://www.ncbi.nlm.nih.gov/pubmed/18781307?dopt=Abstract

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