Lucentis vs Avastin: Which Drug is Better?

Lucentis and Avastin are two drugs used as treatments for wet macular degeneration.  There has been considerable debate over which of these two treatments is best for treating macular degeneration.  Lucentis is an approved drug for the eye disease, while Avastin is an off-label treatment.

As the debate over whether Lucentis or Avastin is better for treating macular degeneration, new research recently reveals that making the choice will be much more difficult.

In a retrospective chart review published in the British Journal of Ophthalmology, it appears that Lucentis or Avastin are equally effective at decreasing macular thickness and volume.  Avastin appears to last longer than Lucentis.

Does this mean that Avastin is better than Lucentis when treating macular degeneration patients?  Not necessarily.

Another paper published in the Graefes Archive of Clinical and Experimental Ophthalmology reveals that Avastin accumulates within retinal pigment epithelial (RPE) cells.  Lucentis however, does not accumulate.  Thus, the study concluded that there are substantial differences in the pharmacokinetics of these two macular degeneration drugs.

A third study published in Investigative Ophthalmology and Vision Science reported that higher does of Avastin resulted in higher cell death of photoreceptors.  This study compared Avastin treatments with Macugen treatments.  Lucentis was not considered as part of this study.

Researchers concluded that the destruction of photoreceptors may be important for patients suffering from a variety of eye diseases, including macular degeneration and diabetic retinopathy, especially if Avastin treatments were continuing for a period of time.

Other studies in whether Lucentis or Avastin is better for treating macular degeneration are continuing.  The debate will continue especially since the cost of these two drugs is substantial.

Comments

  1. Sue Frias says:

    My insurance has just canceled coverage of Lucentis. I have lost the sight in one eye and am loosing the sight in the other held back by theese injections. I am panicking at the thought of my future.

  2. Vern Tolles says:

    Just wondering if you have any information on patients who have had both types?

    • Have had both meds and Lucentis is not worth the extra cost, tho I do not know the details of why Avastin is not approved for this treatment. A new drug now called Eyelea (costs like Lucentis).

  3. Pauline Simmonds says:

    I have had six treatment with avastin for my macular degeneration
    and I don’t feel it is helping my problem.Please let me know what others think of this drug?

    • Unknown how many treatments you need. I read that usually you end up with 20/40 vision which sounds like your case and is like mine. Annoying!

  4. Just got the news today that I will have to start the injections next mon. for my macular degeneration.Which one do i pick. They suggested I get on the internet and research it.I’m so torn from what I’ve read.

    What am i going to be able to do after the injections. They said bring someone with you.

    • Contact Genentech & they will find a charity which might certify you to get Lucentis. I do not know how they make such a decision (they cover the copay), so it might not work. The Chronic Disease foundation is one suchorganization….it may be that you have to be referred TO them.

    • doctor should decide! cost (insurance) is totally important. New drug out now: Eyelea and costs like Lucentins

  5. I was treated with Avastin via intraocular injection in May 2008 for Ddegeneration vessel breakthrough into the retina. My vision began to clear in a couple of days and improved to 20-30 corrected in te eye. About what it was prior. No other breaks in 2 years. A scar from the break. The drug is effective for mmost and paid out of pocket cost about $150 including the dr. visit. My RS considers it an excellent alternative to Lucentis, hithly cost effective and more effective for many patients.

  6. Robert Sommer says:

    I have 21 yr old history of Ocular Histoplasmosis (bilateral) with my first recurrence in one eye in Oct 2009. I began Avastin injections and have successfully completed 4 injections with vision going from 20/40 back to 20/25, what it was before recurrence. In 1988, first occurrence, both eyes were lasered; 5 recurrences in left eye with laser treatments, resulting in 20/400 vision in that eye. The other eye remains 20/25 now, after 4 injections. My doctor says he will continue the injections every 4 to 8 weeks, probably for the remainder of my life. Does anyone else have this prognosis? I can understand WAMD needing this, but Histoplasmosis should not, in my mind. Interested in hearing from anyone with similar or same situation. Thanks. Bob Sommer

  7. Robert Sommer, sorry to say but i am happy to read a story of someboody who has ocular histoplasmosis for so long. I have been diagnosed just over a year ago and had 7 injections with lucentis since, in my left eye. Last one 2 weeks ago. Now leakage has occured in my right eye, tomorrow I will have my first injection in the right eye. My left eye has improved but is not stable. Email me at: sasje74@hotmail.com, love to hear from you! thanks

    • HOW do they make the diagnosis of histoplasmosis? My RS never has said anything about this, but I grew up in St. Louis, Mo. on the Mississippi.

  8. I too have been dealing with Ocular Histoplasmosis in both eyes. It started in my left eye in 2004…having had steriod injections and photodynamic therapy….my left is is now 20/400. In 2007 I started to experience vison problems in my right eye….I have had 6 injections of Avastin and It has helped greatly to keep my vision 20/25. Currently have some leakage but not causing vision problems….Getting injection tomorrow…Doctor wants to switch from avastin to Lucentis…..Concerned about the change.

  9. Hi Matt, I just read on Dr. Randall Wongs website he’s a RS, that they experienced the BEST results from the patients being treated with both Avastin and Lucentis. Hopefully it will be the same results for you! Peggy

  10. I haven’t researched OH in years. I was diag. in 2002 with Ocular Histo. This is when I lost central vision in my RT eye and am legally blind in the RT eye. It was dormant in both eyes for years but it reacted in 2002 a week before I was taken in for emergency hysterectomy. (After the loss I did a great deal of research and the one thing I concluded is, it appeared from the blogs many women at my age 44 had the reaction while there were hormone changes going on in their lives.) I just read “new” OH info on a website; it stated stress is a great factor in bringing it on, great. Last year my eye disease specialist informed me I also have non- age related macugen in the left eye as well as the histo. I feel/see my left eye vision changing, it is making me sad. I have always said it never bothered me losing the RT eye vision but, I know it has. I made an appt this morning for my left eye because I know something is happening. I have been informed through the years at some point I more likely than not I would be legally blind in both eyes. I was told just pray for advances in stem cell research because there is no cure. I’m feeling a down right now, but I’ll pick myself up and move on. Just venting to people who know how I’m feeling and would actually care. When I bump into corners, turn to short and drop things before I have reached the table, it hurts to hear, “oh yeah here we go, I forgot your blind.” That’s’ from the person who is supposed to love me. Just having a pity party.

  11. Ed Schlitt says:

    I have been reeiving Aventis injections for 2 years. My left eye requires monthly treatment, right eye every 3 months. Knowing there is a test between Aventis and Lucentis now nearing completion in about 6 months, perhaps will learn if one is better than the other. My retina specialists both think Aventis is the way to go and especially considering cost comparison. The treatments definitely have helped me, can even read the daily newspaper with plenty of light. How much longer can I take these injections? Today the doctor said as long as needed. God bless you all and I hope you get relief.

  12. Larry Spellman says:

    In 2006, 3 shots of avastin stopped the leakage in left eye. Leakage in left eye started again in 2010 and have had 3 shots = 2 avastin and one lucentis. Waiting for results of study as to which is a better treatment. Supposed to be published in late February, 2011.

  13. My doc suggested both Avastin and Lucantis. I am 58, working. I would like comments about both the injection. please share your experiences of both.

  14. I have had Avastin injections for almost 3 years now. It has saved my vision somewhat in left eye, and much moreso in right eye. I have been able to continue driving due to these injections.

    At first my doctor thought about trying Lucentis for just a couple treatments (due to high cost) to see if any difference than Avastin, but decided not necessary, that the Avastin was doing well as of now.

    If you have not had injections, the discomfort only lasts overnight and much better the following day.

  15. Geri McIntosh says:

    I have age related “dry” macular degeneration. When I received my first shot of lucentis, my vision was closer to 20/20 (I could read the newspaper and see TV reasonably well with my eye glasses). When I received a second shot in January, my R/e vision deminished. I’m astounded that 6 weeks later I’m told I have blind status, I lost 6 lines of eye vision since second shot six weeks ago. (Can no longer read newspaper without magni glass and face features of others blurred and unclear?). I was informed that Macular had moved to L/e so a few days ago I agreed to received my first shot of Avastin. This weekend I will recieve my third shot in the R/E . Worried that 2 shots in two weeks maybe unsafe?

  16. Norman McCollum says:

    I have had 5 intravitreal injestions of Lucentis in each eye with great improvement in my sight for diabetic retinopathy (maculopathy). Unfortunately the funding has dried up and I am appealing against the local health authority descision to stop funding treatment. Since the last injections one month ago reading vision has deteriorated. I hope Avastin is approved soon as it is much cheaper and I gather, does the same job. UK Citizen.

  17. hi anybody, i have ohs in both eyes and being sent to a rs for treatment…….. a shot in the eye is very scary…… please help… is this a painful shot? what can i expect from the first exam? my vision is 20/70 will i still be able to drive? thanks to all who answer, brenda

    • Not so bad as it sounds at all and not painful (only for a milisecond). You cannot wait: it is an emergency since the blood ruins the retinal receptors. You have to keep looking at Amsler Grid.

  18. Bob Cowan says:

    I am scared. I have had one Lucentis shot and do not notice much if any improvement. I have 100% confidence in my doctors and all involved in my study but reading the above questions and comments, I see that this is not an exact science. We all face different results and probably vary with how we control our sugar. I do know we are all luck that we are in 2011 and not 1970 and have the dedicated doctors working on these dreaded and little known eye diseases.

  19. I have had 8 Avastin and 32 Lucentis injections. I have no idea which one is the best, I just trust my opthamologist’s decision. I have lost the sight in one eye and trying desperatly to save the other one so whatever he tells me, I go with.

  20. Great news for the treatment of macular degeneration! Use of a novel anti-platelet-derived growth factor therapy along with Lucentis resulted in a significant improvement in vision vs. ranibizumab monotherapy for the treatment of wet age-related macular degeneration. Take a look at my article on healio.com: http://bit.ly/LlPIAG

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