A cheap, long -approved HIV drug can improve vision in patients with a complication of diabetes more efficiently and much lower than many existing treatments, according to an initial clinical trial. In addition, the drug is taken orally, possibly offering patients an alternative to monthly injections directly into their eyes.
The drug, Lamivudine, could represent an important new choice for millions of patients with diabetic macular edema (DME), a condition that causes fluid accumulation in the retina of the eye. It is estimated that about 1 in 14 people with diabetes develop eye disorder stealing vision and there are more than 37 million adults living with diabetes only in the United States.
An oral drug that improves vision in DME would be a game change player because it would be more convenient for patients than frequent, often monthly eye injections. The mechanism of action of Lamivudine is also different from that of existing treatments, so we could also develop combination treatments. ”
Jayakrishna Ambati, MD, researcher, founding director of the UVA Health Advanced Science Center
Diabetic edema of macular (DME)
Ambati’s associates at the Universidade Federal de São Paulo in Brazil, led by Dr. Felipe Pereira and Dr. Eduardo Buchele Rodrigues, two dozen adults with DME were enrolled in a small randomized clinical trial. Participants were randomly commissioned to receive either lamivudine or harmless placebo, in addition to the injections of the Bevacizumab drug in their eyes, starting after four weeks.
Participants who received Lamivudine showed significant vision improvements even before their first injections. Their ability to read letters in an eye diagram improved in 9.8 letters (about 2 lines in the eye diagram) in four weeks, while the placebo participants saw their ability to reduce by 1.8 letters. One month after Bevacizumab injections, Lamivudine recipients had improved with a huge 16.9 letters (over 3 lines on the eye map), while the placebo group, which received only Bevacizumab, had only increased by 5.3.
The results suggest that lamivudine can work both alone and in combination with Bevacizumab injections, although they will need larger studies to withstand it, the researchers say. However, only Lamivudine could be lifechanging for patients in many areas of the world with limited access to specialty doctors or who are unable to withstand or travel on a monthly eye appointment, Ambati says.
“A cheap 20 -dollar mouth pill that improves vision and more than eye injections that cost up to $ 2,000 a month could be transformed for both patients and healthcare system,” he said.
Researchers believe that Lamivudine is effective against DME because it prevents the activity of inflammation, important factors of our immune system. Inflammation usually act as infections sensors, but have also been involved in the development of DME.
Ambati and his colleagues say that future lamivudine tests should be recorded in a larger number of patients and follow them for more than eight weeks. However, researchers are encouraged by the promising signs produced by their original test. For example, they note that Lamivudine improved vision not only in the first four weeks – when the greatest improvement is usually observed in DME – but also in the next four weeks.
“We have developed a safer version of Lamivudine called K9, which prevents inflammation without the possible side effects of lamivudine,” said Ambati, Dupont Guerry III professor at the UVA School of Ophthalmology School. “So we’re excited by the ongoing and scheduled clinical trials of K9 on DME as well.”
The new findings come warm on the heels of another Ambati discovery, suggesting that HIV drugs can significantly reduce the risk of Alzheimer’s disease. His team has previously noticed, analyzing large health insurance databases, that drugs, called inhibitors of reverse nucleoside transcriptase or NRTIS, can also reduce the risk of macular diabetes and degeneration.
The new clinical trial for DME was proposed by similar findings and depicts the power of what Ambati “Big Data Archeology” calls.
Findings were published
Ambati and his associates published their DME findings in MedicineCell Press’s flagship clinical magazine. The research team consists of Felipe Pereira, Joseph Magagnoli, Meenakshi Ambati, Talita Fernandes de Oliveira, Juliana Angélica Estevão de Oliveira, Vinicius Olivera Pesquero, Lucas Zago Ribe, Dante Akira, Sergio Kona Atala Dib, Nilva Bueno Moraes, Michel Eid Farah, Eduardo Buchele Rodrigues and Jayakrishna Ambati. Jayakrishna Ambati is the co -founder of Iveena Holdings, Iveena Systems and Inflammasome Therapeutics. The full list of authors’ disclosures is included in the document.
Ambati’s survey was backed by the National Institute of Health Eye Institute of the National Institute of Health and the National Institute for Aging, R01EY031039 and R01AG082748 grants and UVA Strategic Investment Fund, Grant SIF167.
