Lucentis May Increase Risk of Stroke

The New York Times reported on Saturday that Genentech posted a letter on its website warning eye specialists of its new eye drug Lucentis, which may increase the risk of stroke for those on Lucentis. Genentech found that patients taking their marketed dose of Lucentis were much more likely to suffer a stroke than patients taking a lower dose.

Lucentis is a recombinant humanized monoclonal antibody.   What it does is that binds to and inactivates vascular endothelial growth factor (VEGF-A) which is considered the dominant inducer to the growth of blood vessels.  Lucentis is a fragment derived from the same antibody.

The idea is that the drug will quell the development of excessive and abnormal blood vessels in the eyes, which is a particular concern of diabetics. Nearly 8 million people have been diagnosed in this country with diabetic retinopathy, a frequent complication of diabetes.  The aim of this medication is to reduce the amount of retinal edema. So the therapy is approved by the FDA for age-related macular degeneration (AMD).  By all accounts, it works.

Not Every Doctor Is Concerned

Nursing-Home-Consent-Form-300x218Some doctors remain undeterred. “Right now, it will have no impact on my use of Lucentis,” a doctor at the Palmer Eye Institute of the University of Miami, wrote to the New York Times in an e-mail message. “When given a choice between a high likelihood of blindness or a 1 percent risk of stroke, I think most patients will choose their vision.”

I don’t know enough about Lucentis to say whether I think this doctor is correct. The problem is, I don’t think Lucentis’ manufacturer knows either.  But I do get what the doctor is saying.  He thinks the risk is worth benefit.  This may very well be true with some patient even if there is a stroke risk with Lucentis.

2018 Lucentis Stroke Update

You would think we would have the answer to this question more than 10 years later, right?  We don’t.  The studies are still conflicting on the question of whether Lucentis can cause a stroke.

Medical Literature If You Are Interested

  • Alvi, R, et al. 2016: Visual outcome of laser treatment in diabetic macular edema: Study from an Urban Diabetes Care Center, Pak J Med Sci. 2016 Sep-Oct; 32(5): 1229–1233.
  • Bressler NM, et. al 2012 ‘Cerebrovascular accidents in patients treated for choroidal neovascularization with ranibizumab in randomized controlled trials’ Retina. 32: 1821-1828.
  • Pratt NL, Ramsay EN, et. al: 2014: Ranibizumab and risk of hospitalization for ischaemic stroke and myocardial infarction in patients with age-related macular degeneration: a self-controlled case-series analysis. Drug Safety. 37: 1021-1027.
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