The Preliminary CATT (Comparison of AMD Treatment Trials) results are in and they support the use of either Avastin or Lucentis for the treatment of neovascular AMD. The May 2011 edition of the New England Journal of Medicine contained an editorial written by Philip J. Rosenfeld, M.D., Ph.D. which stated, “The CATT data support the continued global use of intravitreal bevacizumab as an effective, low-cost alternative to ranibizumab.”Page
Vitamin Palmitate A
The recommendations from the clinical trial are that most adult patients with the common forms of RP take a daily 15,000 IU supplement of vitamin A palmitate under supervision of an ophthalmologist and avoid the use of high dose supplements of vitamin E, such as 400 IU. Consult with your physician regarding dosage for children.
A limited review of sources for vitamin A palmitate indicates that each supplier currently known to us (see below) is a company of good business standing that adheres to generally accepted good laboratory practices for manufacturing their products. The Retina Vitreous Resource Center can make no recommendation of one supplier over another regarding the quality of their product. Comparison and selections are your responsibility. You should call the listed companies for more information. The Retina Vitreous Resource Center has no further information to provide regarding these suppliers. (The prices are subject to change without notice.)
The product described below have not been tested or evaluated by the Retina Vitreous Resource Center to determine their safety or effectiveness. Listing here of these suppliers and their products should not be misinterpreted as a recommendation or indication of proprietary interest in any of these companies.
Sources of Vitamin A Palmitate 15,000 IU
J.R. Carolson Laboratories Inc.
Attn: Customer Service – 1-800-323-4141
10 gel-caps is $8.90
240 gel-caps is $15.50 (shipping and handling $10.00)
Freeda Vitamins Inc.
1-800-777-3737 or 1-212-685-4980
100 tablets is $7.95
What Should You Do To Begin Vitamin A Treatment?
This is a serious undertaking. First consult with an ophthalmologist or another medical doctor. Do not start taking the vitamin A supplements on your own. Your doctor will want to do initial and subsequent annual evaluations, including tests to measure your blood level of vitamin A and to assess liver function. If these tests show that you have a pre-existing liver disease or abnormally high blood levels of vitamin A, your doctor may need to decrease your vitamin A intake accordingly. If you are not going to an ophthalmologist now, we suggest that you seek one who is willing to advise you regarding your eye care.
Since vitamin A in the palmitate form was used in the clinical trial of RP, the recommendations derived from that study apply specifically to the palmitate form. Although some other forms might be effective, that is not known because it was not studied. However, beta carotene, a natural precursor of the active form of vitamin A, is not a suitable substitute because it is not a predictable source of the vitamin.
Other Sources That May Help Retinitis Pigmentosa
1) Lutein 12mg Per Day
Puritans Low price at www.puritan.com
Lutein 6mg 100 caps (buy 1 get 1 free) total $13.59 Take (2) per day. Item #003481.
2) Omega 3 DHA 200mg Per Day
Puritans Low price at www.puritan.com
Omega 3 DHA 100mg soft-gels 120 soft-gels per bottle (buy 1 get 1 free) total $17.59. Take (2) per day item #001032.
– and –
Omega 3 DHA 100mg, soft-gels #30 Take (2) per day. $13.99
Omega 3 DHA can also be found in Salmon and Tuna (1) or (2) 3 ounce servings per week.
If you go to your local pharmacy to purchase Lutein or Omega 3 DHA, be sure the dosage is correct. As stated for the vitamin A, Retina Vitreous Resource Center can make no recommendation of one supplier over another regarding the quality of their product.Page
After a one year delay the CATT Trial will begin recruiting patients in January 2008. It will have two primary purposes:
- Compare the safety and efficiency of Lucentis and Avastin
- Determine whether or not as-needed dosing can produce a visual result that is as robust as what has previously been demonstrated with fixed dosing
The study chairman is David F. Martin, M. D., at Emory University.Page
Dietary intake of Lutein/Zeaxanthin is independently associated with decreased likelihood of neovascular AMD, geographic atrophy and large or extensive intermediate drusen in AREDS report No. 22.
If these cross-sectional results can be confirmed in prospective samples and experimental studies Lutein and Zeaxanthin may be considered an useful agent in food or supplement-based interventions designed to reduce the risk of AMD.Page
POT-4 is a derivative of Compstatin, a peptide that inhibits complement activation. Complement activation plays a significant role in the cause of AMD. POT-4 is initially being developed for treatment of AMD. Potentia Pharmaceuticals, Inc. is beginning Phase I clinical trials in Tucson and Miami.Page
Regeneron Pharmaceuticals, Inc., will be testing the investigational drug, VEGF Trap, in a Phase III clinical trial. VEGF Trap is a human Fc-fusion protein that binds and blocks VEGF in the retina when injected intravitreally. VEGF Trap may prove to be a long acting therapy since it is able to more potently bind VEGF than currently available anti-VEGF therapies. This trial will compare VEGF Trap to Lucentis.Page