New Hope for Wet AMD: Public Funding of Vabysmo Offers Kiwis Less Frequent Treatment Option
A new era in the treatment of wet age-related macular degeneration (AMD) has begun in New Zealand, with public funding now available for the drug Vabysmo (faricimab). This advancement offers eligible patients a less frequent injection schedule, potentially improving quality of life and easing the burden on healthcare resources.
The Silent Thief of Sight: Understanding Macular Degeneration
Age-related macular degeneration (AMD) is the leading cause of vision loss for people over 50, affecting around 219,000 Kiwis. It damages the macula, the central part of the retina responsible for sharp, central vision needed for tasks like reading, driving, and recognizing faces. There are two primary forms: dry AMD, which progresses slowly, and wet AMD, characterized by rapid vision loss.
One woman, based in Ōtaki, discovered the severity of her condition after realizing she couldn’t fully perceive objects with one eye while driving. “Two months later, she was driving to work and realised that she couldn’t see the cars in front of her if she closed one eye.” She was eventually diagnosed with wet AMD after a significant bleed in her eye. Unfortunately, a delay in seeking treatment resulted in irreversible scar tissue. “I’d had a huge bleed [in my eye]. I was told I had macular degeneration, and it had turned to wet macular degeneration. And because I’d left it so long, there was scar tissue, and there was nothing they could do with it.”
The Challenges of Current Treatment & The Impact of Vision Loss
The standard treatment for wet AMD involves regular intravitreal injections – injections directly into the eye – typically with Avastin. While effective, these injections are often required monthly, placing a significant demand on both patients and the healthcare system. “Avastin works, but one of the issues is that we have to do the injections every month,” explains Dr. Francesc March, an ophthalmologist and retina specialist. “A lot of patients have this problem, so it takes a lot of resources helping these patients. And if there’s a delay in administering the treatment, this can [lead to] vision loss.”
The woman from Ōtaki experienced this firsthand, initially receiving injections of Avastin, followed by Eylea (aflibercept) when Avastin’s effectiveness waned. She also experienced the unsettling symptoms of Charles Bonnet syndrome, hallucinations caused by vision loss. “Your brain is getting fractured pieces of information, and so it does its utmost to put them together and makes things [up] that are quite ridiculous … you really do think you’re going mad on top of everything else.”
The impact of vision loss extends far beyond simply not being able to see. She now relies on others for assistance with everyday tasks. “Having to deal with your pride, having to say ‘I’m blind’, because if I go shopping, I can’t read prices on labels. I can’t wear makeup.” She humorously recounts a makeup mishap, requiring eyebrow tattooing as a solution. The practical and emotional costs are substantial, from replacing appliances to forgoing cherished activities. “That loss of independence is hard. I’m an impulsive person, and I have to rely on other people to take me places.” She now fears crossing busy roads and has experienced panic attacks.
Vabysmo: A New Treatment Paradigm
Vabysmo offers a potential solution to the challenges of frequent injections. Administered every four months, it targets both proteins that contribute to bleeding in the eye, offering a more comprehensive approach than some existing treatments. “There are two advantages to Vabysmo,” Dr. March notes. “One is that they have to do fewer injections in the eye; as well, there are patients who may not be responding to the previous medications, and then we can help them.”
The reduced injection frequency could also alleviate the risk of infection associated with each procedure. “Every time they put a needle into your eye, there’s a risk of infection. You need this less often, so you’ve got less risk of infection, less cost getting there,” the patient explains.
While she isn’t yet certain if she’ll meet the eligibility criteria, she welcomes the new option. “I’m hoping I might be eligible … I’ve only got a little bit of sight left, and I don’t want to lose it.”
The Importance of Early Detection and Advocacy
Despite the advancements in treatment, early detection remains crucial. “Some patients cannot be diagnosed in time, because sometimes [they’re] not self-aware,” Dr. March emphasizes. “Even if they are, sometimes they don’t go to receive healthcare on time, or the healthcare system is not responding in time to the needs of the patient.”
The patient urges others to prioritize regular eye tests and advocate for their health. “People need to push for answers and be prepared to advocate for themselves.” She also highlights the valuable support provided by organizations like Macular Degeneration New Zealand, while acknowledging the need for greater awareness and information within eye clinics and opticians.
The availability of Vabysmo represents a significant step forward in the fight against wet AMD, offering hope and a potentially improved quality of life for thousands of Kiwis. .
