A drug used to treat several cancers can also stave off sight loss in elderly people, claim researchers.
A new study shows Avastin is effective in treating wet age-related macular degeneration (AMD), an eye disorder that leads to blindness.
Some doctors have been prescribing the drug for AMD even though it is not licensed for the condition, because it is cheaper than the current treatment called Lucentis.
In tests fewer people on Avastin ‘lost’ letters on eye test charts, and their sharpness of vision improved
As a result the Government’s rationing body is to investigate whether it could provide better value for money for the NHS.
The National Institute for Health and Clinical Excellence (Nice) has been asked by the Department of Health to look at whether Avastin would make a cheaper alternative to Lucentis.
In the latest study, specialists at Moorfields Eye Hospital, London, coordinated research at three UK eye centres involving 131 patients aged around 81 years in 2006.
They were given tiny injections of Avastin into the eye at six week intervals, and the results were compared with two other treatments available at the time or ‘sham’ care.
Fewer people on Avastin ‘lost’ letters on eye test charts, and their sharpness of vision improved.
‘Treatment is associated with a greater chance of moderate vision recovery and a reduced risk of moderate vision loss’ says the study.
The study did not compare Avastin with Lucentis, which has become the gold standard of care on the NHS since it was approved by Nice. Several large trials comparing the two drugs are currently underway.
Lucentis was given the go-ahead for routine NHS use in 2008 after Novartis, the company which markets the drug in Britain, said it would pay for treatment after a year’s course of 14 injections costing around £10,700.
Avastin has not been priced for use in AMD but experts believe it may cost 10 times less.
The drug firm Roche, which is behind Avastin, has not applied for the drug to be licensed for wet AMD and says it remains focused on its use for cancers such as bowel and breast.
The study, published online in the British Medical Journal (BMJ), says Avastin should be implemented immediately in those countries that cannot afford Lucentis.
In an accompanying editorial, Professor Usha Chakravarthy from the Royal Victoria Hospital in Belfast said the trial does not establish whether it is better than Lucentis and unlicensed use should ‘not be encouraged’ until trial results are known.
Wet AMD is caused by abnormal growth of blood vessels around the eye, and can be treated by stopping the growth of a natural protein called vascular endothelial growth factor (VEGF).
Avastin inhibits the function of VEGF to stop tumour growth by preventing the formation of new blood vessels.
Nice usually assesses only licensed drugs but the Department of Health has now asked it to look at Avastin’s potential in AMD even though it is unlicensed for the condition.
It is the first request of its type where an alternative drug is licensed and approved for NHS use.
Barbara McLaughlan, RNIB Campaigns Manager for Eye Health and Social Care said ‘Until robust evidence is available on the safety and effectiveness of Avastin, patients should continue to be treated with the licensed and NICE approved drug.’
Eye health and social care的RNIB Campaigns经理Barbara McLaughlan说：在Avastin的安全性和有效性得到确切证实之前，病人应当继续使用NICE批准的药品。
A Department of Health spokesman said it had asked Nice to ‘explore’ the use of Avastin in AMD and it would be a decision for Ministers whether it was taken further.