Avastin (Bevacizumab)

Avastin is an anti-Vascular Endothelial Growh Factor used to treat wet AMD, retinal vein occlusion, diabetic macular edema, and other causes of macular edema.

What is Avastin?

Avastin is a medicine that blocks the effects of vascular endothelial growth factor (VEGF). It works the same way as Lucentis and Eylea. By blocking the effects of VEGF, it is an effective treatment for macular edema from almost any disease. Macular edema swelling of the center of the retina. It is most commonly used to treat macular edema from age-related macular degeneration, retinal vein occlusion and diabetic retinopathy.

A survey of retina specialists in the United States performed in 2014 showed that Avastin is used about twice as often as Lucentis or Eylea for wet AMD. Avastin is much less expensive per dose than Lucentis and Eylea. A single dose of Avastin costs about $65.00. A single dose of Lucentis is $1950.00 and Eylea is $1850.00. The reason Avastin is so much less expensive is that it comes in a large vial meant for use in cancer patients. Then it is drawn into many small doses that are used for eye injections. A single large vial produces about 20 smaller doses adequate for intravitreal injection.

Avastin was initially approved by the Food and Drug Administration (FDA) as a treatment for different types of cancer. Its use to treat eye disease is considered an "off-label" use. The FDA allows the use of drugs for conditions other than those for which it is approved if doctors are well informed about the product and proof has been shown of the drug's positive effects. Based on a study funded by the National Eye Institute (NEI), a part of the federal National Institutes of Health (NIH), the two drugs have equal effect on visual acuity.

How is Avastin Administered?

Avastin, like all anti-VEGF medications is injected into the vitreous cavity. The medicine wears off and needs to be injected monthly at first. After the first several injections, some patients continue monthly treatment, some patient are treated at increasing intervals and some patients are checked monthly and treated as needed. The initial studies comparing Avastin to Lucentis showed the Avastin is most effective if given monthly.

Intravitreal Injections

How does Avastin Compare to Lucentis?

There have been a few studies comparing the effect of Avastin to that of Lucentis. They show that Avastin is as good as Lucentis when administered monthly and slightly inferior when administered less than monthly. There are no studies comparing the effect of Avastin to Eylea (as of this writing in November 2014). The results of the CATT study are shown in the accompanying graph.