'Breakthrough' drug helps woman
keep her sight

Lawrence Eagle Tribune
10 July 2006

By G. Fraser
Joan Fusco woke one morning two years ago to discover the blinds on her windows were "wavy," and so was the ceiling, and so was the road outside.

"Little did I know that my journey had just begun," said Fusco, now 71. She decided she probably needed glasses and made an appointment with her optometrist. But when she went in for that appointment, her doctor had some startling news.

"I went in to see him and that's when he told me that within two years there was a possibility of me going blind," she said.

Fusco had wet macular degeneration in her right eye. The age-related disorder cuts off oxygen-enriched blood to the macula, or the central part of the retina. And while Fusco's left eye was not affected, her doctor told her it could be damaged within a few years, as well.

But two years later, Fusco said, she has 20/20 vision.

Fusco was treated with Lucentis, a new drug produced by the pharmaceutical company Genetech of Oceanside, Calif. It works by binding and inhibiting a protein that plays a role in the formation of new blood vessels.

The drug received U.S. Food and Drug Administration approval last Friday. Dr. Elias Reichel, Fusco's doctor and the principal investigator in a Tufts Medical Center study that contributed to the federal decision to allow Lucentis into the market, heralded the drug as "a major breakthrough."

Reichel said that photodynamic therapy, the traditional treatment for macular degeneration, amounted to little more than "a lot of hand-holding." With that treatment, only about 2 to 3 percent of patients improved to 20/20 vision. With the new drug, about 30 to 40 percent of people return to 20/20 vision, he said. Fusco said she is grateful she opted to undergo the drug's two-year clinical trial, despite its risks.

By opting to take the Lucentis, which was injected once a month directly into her eye, she had to reject the photodynamic therapy, which had some hope of stopping the continued deterioration of her eyesight. She also ran the risk of being given a placebo treatment.

The study required a control group, a group of people who were told they had been given the drug without actually receiving it. For two years, Fusco didn't know if she was part of that group or not.

"I went to do it because I always had hopes that I was getting the drug," Fusco said. She also said she felt like she was part of something more significant than the treatment of her own condition.

"I was at the front lines of something important here," she said. Reichel agreed that the study was important, saying that an aging population means that more and more people are getting diagnosed with macular degeneration each year.

"It's becoming more of a problem," he said.

He also said it's unlikely that another drug will reach the market after Lucentis, which he said contributes to some improvement in 75 percent of patients. For another drug to reach the market, he said, studies would have to demonstrate that it is as good as or better than Lucentis.

Reichel said he could start prescribing Lucentis in his own practice immediately. For Fusco, who is no longer taking the drug treatments, taking part in a clinical trial has relieved fears she had about becoming dependent on her children. Now, she said, "My vision is excellent. I can drive. I can read prescription bottles and telephone (directories)."

Contact:

William R. Sacco, New England Eye Center – (617) 636-1055 or wsacco@tufts-nemc.org