Age-related macular degeneration (AMD) is the most common cause of blindness in individuals
over 50 years of age. Bevacizumab and ranibizumab are two agents developed by the American
pharmaceutical corporation Genentech, both of which inhibit blood vessel growth factors.
These drugs, when injected intraocularly, reduce the pathological growth of blood vessels in
the macular area of the eye. Bevacizumab (Avastin) is an antibody developed for intravenous
treatment of metastasized colon cancer. Ranibizumab (Lucentis) is an antibody fragment
developed from a similar antibody. It was introduced 2006 as an effective treatment for wet
AMD. Treatment costs are, however, up to 50 times higher compared to use of bevacizumab.
Avastin has shown similar effects to ranibizumab, and has been used off-label in many
countries, both before and after Lucentis received approval. There is thus a recognized need
for large randomized studies to garner proper scientific proof of Avastin's effectiveness
regarding exudative AMD.
LUCAS is a randomized multicenter study, performed in Norway, comparing ranibizumab and
bevacizumab use for AMD. The goal of the study was to demonstrate if the two agents were
equivalent regarding both efficacy and safety. A total of 441 patients with objective
evidence of wet AMD were randomized to a double-blind treatment with ranibizumab or
bevacizumab over the course of 2 years. The treatment interval was determined by a "Treat and
Extend" protocol.