• Eylea found no more effective than Lucentis after two years
  • `Not going to change my treatment approach,' study leader says

Regeneron Pharmaceuticals Inc.’s Eylea injection was no more effective in treating a severe eye disease than Roche Holding AG’s Lucentis after two years, according to findings from a new study that may not be enough to knock Regeneron off its dominant perch in the field.

The study is an update from one published last year, which found Eylea was more effective than Lucentis or another Roche drug, Avastin, in patients with moderate to severe visual impairment due to diabetic macular edema. Regeneron trumpeted those results and attributed its increasing share of the market in part to doctors’ enthusiasm over them.

The earlier trial showing Eylea’s superiority in the initial stages of treatment is reason enough to continue prescribing it over competitors for patients with advanced disease, said John Wells, lead author of the study and a doctor at the Palmetto Retina Center in West Columbia, South Carolina.

“My first reaction was -- that’s great, but you can’t ignore what went on the year and a half before, you’re not going to withhold a better treatment for a year and a half,” just because Lucentis draws even with Eylea eventually, Wells said. He said that for patients with worse eyesight he prefers to prescribe Eylea. “Personally, it’s not going to change my treatment approach.”

In a statement, Roche said it was pleased with the two-year findings. Regeneron’s head of ophthamology Robert Vitti said in an e-mail that Eylea showed strong efficacy in the study compared to Avastin.

Cost Controversy

Eylea accounted for more than 65 percent of Regeneron’s sales last year. The drug, reimbursed by Medicare at about $1,850 an injection, is significantly more expensive than Lucentis, at $1,200 a shot, or Avastin, at $60 per dose. Bayer AG sells Eylea outside the U.S.

“There’s controversy about this in the retina community,” Lucia Sobrin, a professor at Harvard Medical School and eye specialist at Massachusetts Eye and Ear, said by phone. Because it works almost as well as Lucentis and Eylea, “Avastin is way ahead of the others in cost-effectiveness.”

The trial of 660 patients also found that those taking Lucentis suffered more side effects such as stroke and vascular death than those taking either Eylea or Avastin. Both Wells and Sobrin said that finding didn’t line up with data from previous studies, and it wouldn’t weigh against prescribing Lucentis in their own practices.

The study, presented Saturday at the Macula Society meeting in Miami Beach, Florida, was funded by the U.S. National Institutes of Health and published in the journal Ophthalmology.

Regeneron, based in Tarrytown, New York, rose less than 1 percent Friday to close at $394.23. Basel-based Roche gained 1.1 percent to 260.10 Swiss francs in Swiss trading Friday.

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