An inexpensive pill for treating HIV could become an alternative to injections for diabetic eye disease, a small study suggests.
"An oral drug that improves vision in diabetic macular edema (DME) would be a game changer because it would be more convenient for patients than frequent, often monthly, injections into the eye," study leader Dr. Jayakrishna Ambati of UVA Health in Charlottesville, Virginia said in a statement.
At the start of the study, 24 patients in Brazil with DME were randomly assigned to receive Viiv Healthcare's oral antiviral drug Epivir (lamivudine) or a placebo for four weeks, to be followed by a standard injection of Roche's Avastin (bevacizumab) into the clear gel-like area that fills the eye between the lens and retina.
After that initial four weeks, the ability to read letters on an eye chart had improved by 9.8 letters, or about 2 lines on the eye chart, in the lamivudine group, while it had decreased by 1.8 letters in the placebo group.
At four weeks after the Avastin injection, the lamivudine recipients had improved by 16.9 letters, more than 3 lines on the chart, while the group that got just Avastin improved by only 5.3 letters.
The HIV drug inhibits an early step in the inflammatory process that leads to DME, the researchers explained in a report published on Tuesday in the Cell Press journal Med.
That mechanism of action is different from existing treatments, "so we could also develop combination therapies," Ambati said.
While the results suggest that lamivudine may work both with and without Avastin injections, the Viiv drug alone could be life changing for patients in regions with limited access to specialty doctors or who are unable to afford or travel to monthly eye appointments, Ambati said.
"A $20-a-month or even cheaper oral pill that improves vision as much as or more than therapy with injections into the eye that cost up to $2,000 per month could be transformative both for patients and the healthcare system," Ambati said.
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