Let’s look at the dark side of the anti-VEGF story. We’re going to talk about manipulation of study data, systemic side effects, ocular side effects, and payoffs and bribes.
Manipulation of Study Data
As I mentioned, the dark side is manipulation of study data. I can’t believe you can lose 15 letters on the eye chart and have it still be defined as stable vision. If I have a patient who loses even two or three letters on the eye chart, I consider that a failure when I’m doing alternative treatments.
Systemic Side Effects
Systemic side effects have been reported. There are thromboembolic events such as stroke, myocardial infarction and angina, gastrointestinal perforation, bleeding ulcer, hemorrhage, hypertensive crisis, congestive heart failure, and neutropenic sepsis. Neutropenic sepsis means there’s loss of white blood cells, which leads to a systemic infection.
All of these are very serious systemic side effects. As an alternative doctor, I believe that no matter what treatment you institute, it should have no or extremely minimal side effects.
The FDA has stated that Avastin, when used to treat cancer patients, has been shown to increase risk of stroke and heart attack.
Patients who are receiving blood-thinning agents like aspirin must be precluded from using Avastin. Of course, the use of aspirin brings up a whole other issue. I believe the use of aspirin is actually contributing to the incidence of wet macular degeneration. Those of you who are taking aspirin should consult with your doctor. Is it absolutely necessary?
Ocular Side Effects
Let’s look at the ocular side effects. Endophthalmitis, which is severe infection that usually leads to blindness, can occur. You can develop a retinal detachment with these injections. Glaucoma can develop. You can develop cataracts. More recently, a shocking study was reported to show that retinal atrophy is a very common occurrence after repeated injections of these agents.
A team of researchers led by Dr. Grunwald at the University of Pennsylvania published a study of over 1,000 CATT patients whose color fundus photos or fluorescein angiograms showed no visible signs of geographic atrophy at enrollment.
After two years, the researchers found that geographic atrophy, or retinal atrophy, had developed in 187 patients, or 18.3 percent of those being studied. That’s close to one out of five patients. It’s 20 percent incidence of developing this serious complication.
On the left, we see an eye that has some areas of bleeding in the center. It’s classic for wet macular degeneration. After injections, you see death of retinal cells: atrophy.
Payoffs and Bribes
We also have payoffs involved. The New York Times has revealed a secret rebate program which Lucentis’s manufacturer, Roche, has recently started by offering physicians ﬁnancial inducements, about $60 per dose. Many retinal specialists perform over 1,000 injections per year, and some perform far more. Therefore, you can see there’s a financial incentive. Are they looking out for your best interests, or this is a financial incentive to institute these injections?
Why alternative treatments?
Let’s look at alternative treatments. First, there are no systemic side effects, or very few. There are no ocular side effects. These treatments are safe. There hasn’t been any study data manipulation. There’s no kickback from big pharma because big pharma does not own these therapies.