糖尿病黄斑水肿的新疗法在欧洲和加拿大可用

导致失明的眼病一直是糖尿病患者最担心的疾病之一，其中最常见的眼病被称为糖尿病视网膜病变。事实上，据估计，在美国，40%到45%的糖尿病患者患有某种形式的糖尿病。糖尿病视网膜病变涉及视网膜(眼睛感知光和颜色的部分)周围血管的损伤，这可能导致多种失明。例如，在糖尿病性黄斑水肿(DME)中，糖尿病性视网膜病变会导致血管向黄斑渗漏液体，黄斑是视网膜中负责清晰、笔直视力的部分。液体会导致黄斑肿胀，导致视力障碍。每年在糖尿病患者中出现高达7.5万例二甲醚新病例，其后果是可怕的——二甲醚是美国工作年龄人群失明的主要原因。目前，DME治疗的金标准是激光手术，这包括封闭泄漏的血管，以减少黄斑周围的液体量。在研究中，激光手术在三年内将中度视力丧失的风险降低了50%，但手术也可能是昂贵的和使人衰弱的——特别是长期而言。然而，一种可能更有效的新疗法最近在欧洲和加拿大获得批准:一种名为Lucentis的药物。由罗氏(Accu-Chek胶条的制造商)制造，由美国基因泰克(Genentech)和诺华(Novartis)在国际上销售，Lucentis已经被用于治疗其他眼部疾病，包括湿性老年性黄斑变性(wet - AMD)。 It is injected monthly or less frequently into the eye, where it works by blocking the activity of a molecule (VEGF) that promotes blood vessel growth and blood vessel leakiness. In European studies, Lucentis provided people with DME greater improvements in visual acuity (measured by the number of letters read on an eye chart) versus laser therapy or non-active injections (the control treatment) after one year. More recently, two-year studies conducted in the US have shown that Lucentis improves the eye function of people with DME compared to placebo (inactive) injections. In all these studies, Lucentis has been found to be generally safe and well tolerated; the major downside seems to be price, roughly $2,000 per shot, before insurance. (Avastin, a drug similar to Lucentis that is approved for treatment of cancer, is already used ‘off-label’ by some doctors to treat DME; it is dramatically cheaper per injection, but its safety and efficacy have not been as thoroughly investigated.) Excitingly, Lucentis itself is now on track for use in DME in the US. Earlier this month, Lucentis was submitted to the FDA for the treatment of DME, placing a possible approval around the summer of 2012. --BK