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Title: Combination Therapy Improves Visual Acuity For Previously Treated Macular Degeneration Patients: Presented at ARVO
URL: http://www.pslgroup.com/dg/2206DE.htm
Doctor's Guide
April 30, 2008

By Cameron E. Johnston

FORT LAUDERDALE, Fla -- April 30, 2008 -- Patients with age-related macular degeneration who have failed therapy with either photodynamic therapy (PDT) alone, or with a vascular endothelial growth factor inhibitor (VGEF) such as ranibizumab may experience significant improvements in visual acuity when treated with a combination of PDT, anti-VEGF, and steroids, according to research presented here at the Association for Research in Vision and Ophthalmology (ARVO) 2008 Annual Meeting..

Albert Augustin, MD, Director, and Professor of Medicine, Klinikum Karlsruhe, University of Karlsruhe, Karlsruhe, Germany, presented data from a cohort of 104 patients with choroidal neovascularisation secondary to age-related macular degeneration who received the triple-therapy regimen of reduced-fluence PDT, followed 16 hours later by bevacizumab 1.5 mg and dexamethasone 800 mg.

At the end of 70 weeks' follow-up, patients had a mean improvement in visual acuity of 8.9 letters. There was also a mean reduction in central retinal thickness of 171 microns, from 469 microns at baseline to 292 microns at follow-up.

Importantly, Dr. Augustin said in a presentation on August 28, this benefit was seen regardless of a patient's lesion size or subtype.

Moreover, the improvements seen with the triple therapy were substantially superior to what has been seen in previous studies with PDT alone, he said.

Overall, 18% of the patients in this study remained stable, while 41% had an improvement of 1 to 3 lines, 19% had an improvement of 4 to 6 lines, and 4.8% had an improvement of 7 or more lines.

According to Dr. Augustin, the rationale for triple therapy stems from the fact that bevacizumab is beneficial for stopping the growth of new blood vessels, while verteporfin PDT eradicates existing neovascularisation. At the same time, the steroid dexamethasone counteracts the inflammation that PDT causes, and has its own antiangiogenic effects.

The triple treatment seems to offer a synergistic reaction that provides a lasting benefit to a substantial number of patients who receive it, Dr. Augustin concluded.


[Presentation title: Triple Therapy for the Treatment of Wet AMD. Poster 1167]

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