To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Triple Therapy Offers Lasting Improvement in Vision in Patients With Macular Degeneration: Presented at AAO URL: http://www.pslgroup.com/dg/21713A.htm Doctor's Guide November 13, 2007
By Cameron E. Johnston NEW ORLEANS, LA -- November 13, 2007 -- A powerful cocktail of three separate treatment modalities may be the best option possible for treating neovascularisation secondary to age-related macular degeneration (AMD) and could offer much better long-term benefit compared with any available monotherapy regimens. The results from studies using this triple therapy regimen were presented here on November 9 in a Retina Sub-specialty Day symposium at the annual meeting of the American Academy of Ophthalmology (AAO). According to Albert Augustin, MD, Director and Professor of Medicine, Klinikum Karlesruhe, University of Karlsruhe, Karlsruhe, Germany, all the treatment options available at this time to treat macular degeneration have some benefits, but they also carry their own risks or limitations. For example, while intravitreal bevacizumab is very good at stopping the growth of new blood vessels, it also causes a rebound effect so as it wears off, there will be a compensatory burst of new vessel growth. Similarly, while verteporfin photodynamic therapy (PDT) eradicates existing neovascularisation, it causes inflammation within the eye. And while intravitreal steroid injections counteract this PDT-induced inflammation, they can also dramatically increase intraocular pressure, leading to more severe damage to the optic nerve. In studies conducted by Dr. Augustin's team, 104 patients received the triple therapy -- consisting of 1.5 mg of bevacizumab and 800 mg of dexamathasone, followed 16 hours later by PDT therapy with verteporfin. Dr. Augustin explained that bevacizumab prevents new blood vessel growth, while dexamethasone suppresses secondary vascular endothelial growth factor (VEGF) upregulation and also helps to minimise primary VEGF expression. Dexamethasone also reduces the inflammation caused by the PDT. Finally, PDT eradicates the existing neovascularisation. Therefore, the three treatments seem to offer a synergistic reaction that provides a lasting benefit to a substantial number of patients who receive this triple therapy. At the end of 62 weeks follow-up, the mean increase in visual acuity was 1.7 lines, or 8.9 letters. Similarly, the mean reduction in central retinal thickness was 171 microns, from 469 at baseline to 292 at follow-up. These improvements were seen across all lesion sizes and compositions, Dr Augustin said. Moreover, the improvements seen with triple therapy were substantially superior to what was seen with PDT alone, where the an earlier study showed losses in visual acuity of 13.4 lines in the study group and 19 lines in the sham (placebo) group. Overall, 18% of patients remained stable, while 41% had an improvement of one to three lines, 19% had an improvement of four to six lines, and 4.8% had an improvement of at least seven. A further important consideration with triple therapy regimen is that it appears to have a strong lasting benefit, with a relatively small percentage of patients needing retreatment. This is an important point considering that one single treatment with standard anti-VEGF treatments are costly and require monthly administration. It also means that patients may be able to take "an anti-VEGF holiday" so there is less risk of developing new VEGF receptors, Dr Augustin said. [Presentation title: Triple Therapy: Avastin + Photodynamic Therapy + Steroids.] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.