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Vol. LXV, No. 47
Wednesday, November 23, 2011
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A New Drug to Treat Macular Degeneration Was Tested in Trials by Local Physician

Anne Levin

As recently as five years ago, those who suffered from age-related macular degeneration had to resign themselves to the frightening probability that they would lose their ability to see. That was before two drugs, Lucentis and Avastin, arrived on the market and considerably approved the odds.

Now comes Eylea, a drug that promises less frequent treatments, which involve injections into the eye, and costs slightly less. Approved late last week, the drug was tested in clinical trials at the offices of local ophthalmologist Jonathan L. Prenner, who treats patients in Lawrenceville and New Brunswick and also teaches at Robert Wood Johnson University Hospital.

“We have a clinical trial center where we test lots of different drugs. We used Eylea from the early phase through the latest phase,” Dr. Prenner said on Monday, November 21, adding that he would administer the first dose to a patient the following day. “The big news is that we have a new drug for macular degeneration. We’re proud we were able to be a part of its development.”

Eylea was developed by Regeneron Pharmaceuticals and was approved last Friday by the Food and Drug Administration. The drug is geared to patients with wet macular degeneration, which is more severe than the dry form. Patients who have been getting injections of Lucentis approximately every four weeks will be able to have treatments of Eylea every eight weeks. “Eylea has been shown to be comparable to Lucentis when given at the same frequency. And when given at half the time, you get the same outcome,” said Dr. Prenner.

Like Lucentis and Avastin, Eylea is designed to block the action of the vascular endothelial growth factor, a protein that causes blood vessels to leak fluid into the eye. Dr. Prenner thinks it will benefit those for whom the earlier drugs have not been effective.

“We think, but don’t know, that many patients who have not responded well to Lucentis may benefit from Eylea, because it has a higher affinity for the target molecule,” he said. “Eylea blocks the vascular growth factor at a higher affinity, so it can be more effective on a gram-by-gram basis. That’s the potential advantage. It has done well in testing, and now we’re going to see how it does in real life.”

While the drug has been approved for macular degeneration, studies are ongoing on its effectiveness for other conditions such as the retinal problems of diabetics, Dr. Prenner said. Previous to new drug’s approval, he has used Lucentis in his practice rather than Avastin, which is also a cancer drug, because of recent concerns about its safety.

There are no similar worries about Eylea, according to Dr. Prenner. “In the large-scale trial, there was no safety concern,” he said. “We are very confident that Lucentis is exceptionally safe. We don’t know what the new drug will do in its later trials, but there is no reason to think it won’t be safe.”

Dr. Prenner credits his patients with helping to ensure the effectiveness of Eylea. “We’re proud of the fact that we’re a center for investigative eye research in New Jersey,” he said. “The only reason these things are developed is that patients are willing to participate in clinical trials. Our patients have been willing to participate, taking a little risk, and a lot of them have benefited from these drugs years earlier than they could have done otherwise.”

An assistant clinical professor in the departments of Pediatrics and Ophthalmology at Robert Wood Johnson University Hospital and a member of the board of directors of the American Society of Retinal Specialists, Dr. Prenner was the former president of the New Jersey retina society. He is assistant editor of RETINA: The Journal of Retina and Vitreous Diseases.

For Dr. Prenner, the emergence of the new drug is the latest in a promising series of developments. “Five years ago, we used to watch everyone go blind,” he said. “Now, they don’t. It’s amazing. It makes my job so much less depressing.”

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