A new treatment for dry age related macular degeneration
To date, we have been able to reverse visual loss in patients with wet age related macular degeneration with the use of anti-VEGF drugs such as Avastin®, Lucentis® and EYLEA.®.
But what about dry age related macular degeneration?
We have discussed the use of stem cell treatment in dry age related macular degeneration in my recent post but there is a new medicine being investigated, which is showing rather promising results.
Lampalizumab is a medicine made by the same people who gave you Lucentis® (Roche) – the trade name for Ranibizumab) and has been designed to treat dry age related macular degeneration. Lampalizumab is a monoclonal antibody drug that targets and blocks a molecule called Factor D.
Factor D is a molecular enzyme that makes up part of the inflammatory pathway that is thought to be linked to patients who have dry age related macular degeneration.
What do we know so far about lampalizumab and its effectiveness in treating dry age related macular degeneration?
The first study of this medicine was the MAHALO trial, which was designed to look at the safety and preliminary effectiveness of the drug.
Delivery of the drug is similar to anti-VEGF drugs whereby it is given by an injection into the vitreous cavity of the eye known as an intravitreal injection.
It also needs to be given at regular monthly intervals because its effects wear off quickly.
The MAHALO trial showed that lampalizumab was safe with no significant adverse effects.
The exciting news is that it also showed that medicine slowed down the progression of geographic atrophy (one form of dry age related macular degeneration) in 20% of patients.
Patients who had a specific inflammatory marker in their blood were shown to do even better in slowing their disease down with a 44% response rate.
There are now larger studies underway that are investigating lampalizumab in more detail and for a longer period so we should have some definite answers in the next year or two on how to use it and who would benefit the most.
What can we conclude from this new treatment, lampalizumab now?
- It is safe.
- It is unlikely to reverse damage from dry age related macular degeneration.
- It appears to be able to slow down the progression of geographic atrophy (one form of dry age related macular degeneration).
- If you have a specific inflammatory marker in your blood, you will be more likely to respond to treatment.
- It appears to more of a prevention treatment than a curative treatment.
- The medicine is likely to be more effective if it is given to patients with early rather than advanced disease.
- It is not commercially available yet.
We will have to wait and see what the next trials bring and I will update you once those results are through.
In the meantime, if you are worried that you have age-related macular degeneration and would like a private consultation to discuss things further please ring me on 020 7305 5063 and I would be happy to chat to you.