A presentation yesterday at the American Academy of Ophthalmology caught my interest. There are two sustained-release steroid implants that are injectable, making it possible to use these within the office setting. The two that I’m watching are the Alimera Iluvien fluocinolone acetonide resevoir implant, which contains half the drug as the Retisert implant to decrease the side-effects seen with Retisert. It’s implantable with a 25-gauge needle and floats in the vitreous. The phase 3 clinical trial results for DME may be out by the end of this year.
The other product is Allergan’s Ozurdex (called Posurdex everywhere except in the US). It’s also an injectible implant that floats in the vitreous through a 22 gauge system, but contains dexamethasone. It has been FDA approved as of June 2009 for persistent macular edema due to vein occlusion. The phase 2 trials reported at the AAO meeting involving DME patients showed “35 percent of eyes receiving 700 micrograms improved 10 letters or more by Day 90, compared with 24 percent of those receiving 350 micrograms, and 13 percent in the observation group.” (from Academy Live email from the AAO)
I like the Alimera product because it is implantable through a 25 gauge system. The 22 gauge system required to implant the Allergan product is likely to require sutures more frequently to close to wound. However, the advantage of the Allergan product is that it is completely biodegradable, whereas the Alimera product leaves behind the core which contained the drug. This floats around in the vitreous, presumably forever.
