RNIB bases its assessment of the clinical effectiveness of new treatments on evidence from randomised control trials. As a patient group, RNIB has concerns over the use of Avastin for the treatment of wet AMD because no trials have been performed to establish its safety and efficacy or use in the eye.
RNIB is aware of positive reports regarding the use of Avastin for treating wet AMD. While no adverse events have been reported in association with the use of Avastin for the treatment of wet AMD, there is anecdotal evidence that it has been linked to severe adverse effects, including heart attacks.
The lack of reported adverse events has been raised as a point for concern by Winfried Amoaku, consultant ophthalmologist. In "Eye News" (August/September 2006), he wrote: "The assertion that more than 10,000 intravitreal Avastin injections have been given worldwide without any complications is extremely worrying as this is statistically impossible. The implication: complications are not looked for or remain unreported!"
Until clinical randomised trials have been conducted to show that Avastin is safe and effective as a treatment for wet AMD, RNIB cannot recommend the use of the drug to patients. We appreciate that patients rely on their consultant's advice as to the best course of treatment. Where consultants recommend Avastin it is essential that they provide patients with full information about all available options (PDT, Macugen and Lucentis) and that any indemnity issues are resolved prior to treatment.