Friday, October 12, 2007

Avastin & Lucentis

Genentech is notifying ophthalmologists of a change to the distribution of Avastin (a cancer drug also being used to inhibit AMD associated retinal bleeds). Avastin sells for about $50 per dose vs. Lucentis, the new Ocular-specific version of Avastin being used in new AMD clinical studies, which we're told will cost the patient somewhere in the range of $2,000 per dose.

Beginning November 30th, the Lucentis compound must be ordered directly from Genentech, rather than purchased from a compounding pharmacy.

Both versions of this drug have been linked to increased risk of stroke.

The FDA and Genentech claim to be concerned about sterilization issues involved when compounding pharmacists divide Avastin into tiny portions for ocular use.

Wednesday, October 10, 2007

Glycemic Index & Eye Health

Researchers concluded, in a recent study published in the American Journal of Clinical Nutrition, that consuming foods high on the glycemic index can increases the risk of developing age-related macular degeneration (AMD).

The glycemic index is a measurement of the extent to which foods raise blood sugar levels. Past studies have suggested a link between diets containing high-glycemic-index foods and a higher risk of heart disease and diabetes.

Scientists from the Center on Aging at Tufts University obtained dietary information from 4,099 non-diabetic participants ages 55-80 years (56 percent women) in the Age-Related Eye Disease Study (AREDS). A total of 8,125 eligible eyes at baseline were classified into 1 of 5 AMD groups according to the size and extent of pathological growths known as drusen, the presence of atrophy, and neovascular changes.

Compared with subjects who consumed lower glycemic-index foods, subjects who consumed foods with the highest glycemic index had a significantly higher risk of developing drusen-related damage associated with AMD. Consuming foods with a high-glycemic index also appeared to increase the severity of AMD. For subjects who consumed more high-glycemic foods than the average person their age, there was a 49 percent increase in the risk of advanced AMD.

The study authors concluded that “20% of prevalent cases of AMD would have been eliminated if the AREDS participants consumed diets with a dietary glycemic index below the median.” They went on to state that “a reduction in the dietary glycemic index, a modifiable risk factor, may provide a means of diminishing the risk of AMD.”

This is very important news!

Monday, October 8, 2007

Health Rights: Smoke Free Living

Two California cities will vote this month on unprecendented legislation that will ban all smoking inside apartments and condos.

This legislative push, which has triggered death threats against both cities council members by "my home is my castle" smokers, is controversial in spite of mounting scientific evidence that no-level of secondhand smoke is risk-free.

The closeness of most apartment and condo units allows smoke to waft easily from the doors and windows of one unit to those of other units. At the very least, this drifting smoke is a nuisance and on that account alone can be restricted.

Noises, smells, and a host of activities in one's home that adversely effect other's enjoyment of their living space can, and is, regulated. The only difference with cigarettes is that Americans have been bombarded with advertising and movie images of smoking that link smoking with individuality and independence.

When the Surgeon General issued his landmark study suggesting smoking was hazardous to human health, Big Tobacco's immediate response, among others, was an ad campaign linking smoking with rugged American individualism- the Marlboro Man. The message: society and doctors be damned, like a cowboy on the open range, I'll do what I please and I don't care who it harms.

The reality is that cigarettes are not symbols of freedom and individualism, but are symbols of addiction, cancer, death, disease, ignorance, and dependence.

The sooner Americans finally get over their Marlboro Man complex, the sooner sensible laws will be enacted. The Marlboro Man, by the way, died of lung cancer.

If the ophthalmic and optometric medical communities truly believe that living and working in smoke free environments will help prevent degenerative eye disease, improve overall public health and lower the societal cost of healthcare, we need to support this type of legislation.