Choosing between Vabysmo and Avastin can be difficult. Both are Food and Drug Administration (FDA)-approved treatments for patients with eye diseases that can result in vision loss. However, they have different mechanisms of action, benefits, and risks. This document provides details on Vabysmo and Avastin to help you select the treatment that best fits your needs.
What Are Vabysmo And Avastin?
Vabysmo is a newer treatment for eye diseases and was recently (in 2022) approved by the FDA for the treatment of wet age-related macular degeneration (AMD) and diabetic macular edema (DME). Vabysmo contains faricimab, a dual-action injectable.
Avastin is a cancer drug that has been used for many years to treat chronic eye diseases (wet AMD and DME) through an off-label use. Avastin contains bevacizumab, which is an anti-VEGF (vascular endothelial growth factor) that blocks. Both Vabysmo and Avastin are administered by eye injection and reduce the accumulation of fluid beneath the retina.
How Do They Work?
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Vabysmo’s Dual Action
Vabysmo is said to provide a dual-action approach to treating an eye disease. Vabysmo uses dual-action protection by blocking both proteins (VEGF(A) and Ang-2) to reduce vascular leakage and, therefore, improve blood vessel stability. By blocking both proteins, Vabysmo may generally reduce leakage, require less frequent dosing, and provide greater durability of response. This suggests that Vabysmo may help achieve better outcomes and more stable vision.
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Avastin’s Single Target
Avastin works differently from Vabysmo, which blocks VEGF-A. VEGF-A promotes neovascularization (abnormal growth of blood vessels). The benefit of Avastin is that it blocks VEGF-A, thereby reducing fluid accumulation and slowing vision loss in retinal disease.
A significant distinction is Vabysmo’s dual-target mechanism that could reduce the number of injections.
Treatment Frequency
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Dosing with Vabysmo
Vabysmo starts therapy with injections every 4 weeks. After that, patients may qualify for injections every 12 to 16 weeks. This gives patients the convenience of fewer visits to the doctor’s office and reduces the treatment burden.
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Dosing with Avastin
Avastin has to be injected more frequently. Most patients require injections every 4 to 6 weeks. The shorter therapy duration means more clinic visits, which can be burdensome for some patients.
Vabysmo requires fewer injections and, therefore, fewer visits to the clinic.
Effectiveness
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Both Vabysmo and Avastin are effective treatments for eye diseases. Studies consistently report that Avastin improves vision in 80% or more of patients with DME. Additionally, compared to baseline scores, there is a clinically significant improvement in visual acuity at 8 weeks post-injection. Macular swelling decreased by an average of 33%.
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Vabysmo provides similar evidence of effectiveness. Due to its dual mechanism, Vabysmo may offer an added benefit by allowing longer-lasting outcomes in some patients compared with Avastin. For most patients, however, there is no difference in visual acuity associated with the two medications.
Both medications are effective for maintaining and improving vision.
Side Effects
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Cataracts and eye redness have been reported as the most common side effects. Some patients may experience eye pain or floaters. Increased eye pressure after injection may also occur.
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Rare but serious side effects associated with Vabysmo include endophthalmitis (an eye infection), retinal detachment, retinal vasculitis, ocular blood vessel blockage, and severe allergic reactions.
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Common side effects of Avastin are similar to those of the other anti-VEGF agents and include eye inflammation and bleeding. Increased eye pressure is also noted.
Both drugs require monitoring after each injection. If you experience any change to your vision, contact your doctor immediately.
Cost Comparison
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Vabysmo costs $2,289.65/treatment in the USA. Most patients have insurance to help cover the cost or have access to assistance programs.
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Avastin is significantly cheaper, and $500 to $600/vial in the USA. Many hospitals will also break a vial up to save money.
Avastin is a cost-effective option for patient care. It will be helpful for patients with limited insurance.
FDA Approval Status
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Vabysmo is FDA-approved for wet AMD, DME, and retinal vein occlusion after ample testing in clinical trials.
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Avastin is NOT FDA-approved for use in the eye, but it is utilized off-label. There has been significant research on the use of Avastin in the eye.
Multiple studies have shown that Avastin is a safe and effective treatment for patients.
Both drugs are considered safe treatment options when administered by a trained specialist.
Who Should Choose Vabysmo?
Vabysmo is appropriate for patients who want to have fewer injections, have wet AMD or DME, can afford the higher cost of treatment, prefer getting an FDA-approved drug, or need to extend the dosing interval.
Patients with other medical conditions should discuss the risks associated with higher medication loads with their doctor. Potential patients with high blood pressure or diabetes should be monitored closely while on the medication.
Who Should Choose Avastin?
Avastin is right for patients who need an affordable option to treat their eye disease, have no or limited insurance coverage, do not mind more frequent injections, live in a rural or remote location where obtaining Vabysmo is impractical, and have previously responded well to anti-VEGF therapy.
Patients will see the doctor and have their eyes checked before each Avastin injection, just as with Vabysmo, to rule out any infections.
Making Your Decision
There are many variables to take into consideration:
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Cost: Avastin is significantly less than Vabysmo.
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Convenience: Vabysmo will require fewer visits.
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Insurance coverage: what your plan covers now has increased importance.
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History on the treatment history forms: what have you been on previously, and how have they worked for you in the past?
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Follow your doctor’s recommendations: it is best to take their medical advice.
Both medications are effective for treating retinal diseases, and the insurance, financial, and convenience factors will guide your decision.
RVAF – Expert Care For Your Precious Sight
Vabysmo and Avastin create an excellent option for the treatment of wet AMD and diabetic macular edema. Vabysmo is longer-acting, with dual-action VEGF inhibition, and provides longer dosing intervals. Avastin can also be a cost-effective medication with proven results.
The treatment decision you make will depend on your condition, budget, and lifestyle. You may consult with your retina specialist to better understand what the best treatment is for your condition.
At RVAF, our retinal specialists have years of experience treating retinal diseases with specific and personalized care. We offer both Vabysmo and Avastin treatments. Schedule your consultation today and take the first step toward a clearer vision!