October 17, 2005.
Eye doctors meeting in Chicago this week are buzzing about a new generation of drugs to fight age- related macular degeneration, the leading cause of blindness in the elderly. In clinical trials, the new drugs are slowing vision loss in many patients and even improving vision in some people.
"It's the first time we've had any hope," said Dr. William Rich of the American Academy of Ophthalmology, which is meeting at McCormick Place.
But the drugs are expected to cost thousands of dollars a year, and require shots in the eye as often as once a month.
More than 10 million Americans have macular degeneration. Symptoms include blurry or distorted vision and changes in color in the central part of the vision field.
The drugs treat the so-called wet form of macular degeneration, in which abnormal blood vessels leak fluid and blood under the center of the retina. The drugs block a protein that jump-starts blood vessel growth and leakage.
One already on the market
One such drug already on the market is called Macugen. Another drug, Avastin, is approved for colorectal cancer, but doctors are legally using it "off label" for macular degeneration. A third drug, Lucentis, is in clinical trials and could be approved in the next year or two.
A study of Lucentis that included 716 patients found as many as 34 percent had improved vision. Nearly 40 percent could see 20/40 or better after 12 months, compared with 11 percent in the control group. Another promising drug, in early development, is called Cand 5.
At a news conference, ophthalmologists said the drugs should be taken as early in the disease as possible for best results. Taking drugs in combination also might improve results.
Patients will need to go to the doctor's office for the shots. Since many are too old or can't see well enough to drive, caregivers will have to transport them. "It's a burden, with the carrot being vision improvement," said Dr. Susan Bressler of Johns Hopkins University.
Many patients initially are reluctant to get eye shots. But patients receive anesthetic eye drops, and most get used to the injections.
Costs of the drugs will range from $700 to $16,000 per year, Rich said. If half of the 200,000 patients diagnosed each year take the drugs, the total cost could range from $1 billion to $5 billion per year, he added.
"It's a big number."
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