Macugen for AMD
Michael Ulbig (Munich)
Macugen is launched on the German market by end of June 2006. It is the first anti VEGF drug for intra-vitreal application and treatment of age-related macular degeneration (AMD). Other compounds such as Lucentis or Avastin are either not available as yet or are limited to off label use. Macugen blocks the 164/5 isoforms of VEGF whereas Lucentis and Avastin block all isoforms. Whether this is an advantage or disadvantage remains to be answered. Macugen can be used for all forms of wet AMD and the risk for a pigment epithelial rip seems to be low. A comparison of the Marina and Vision studies is presented although the comparison of different study populations is questionable. Macugen is most effective for early and small neovascular lesions. In this subgroup an improvement of visual acuity can be achieved. However more data and experience is needed to compare and evaluate the effects of different anti VEGF drugs.