What’s the difference between Eylea, Eylea HD, and Avastin?
Eylea, Eylea HD, and Avastin may all be used to treat neovascular (wet) age-related macular degeneration (AMD), as injections into the eye (intravitreal injections). Both Eylea and Eylea HD are FDA-approved for this indication, but use of Avastin is off-label (not an FDA-approved indication - although it has been used for this purpose since 2005). Eylea HD is a longer acting version of Eylea (see What is the difference between Eylea and Eylea HD?).
They are all VEGF inhibitors and work by blocking VEGF, a signal protein that stimulates the growth of new blood vessels. Abnormal blood vessel growth from existing blood vessels (called angiogenesis) is associated with the progression of degenerative eye conditions such as neovascular AMD.
The main differences between Eylea, Eylea HD, and Avastin are:
- Eylea is FDA-approved to treat neovascular AMD but the use of Avastin for this purpose is off-label (not FDA approved), although Avastin intravitreal injections have been used for neovascular AMD since 2005. Eylea and Eylea HD are also for other eye conditions such as Diabetic Macular Edema (DME) and Diabetic Retinopathy (DR). Eylea is also approved for Macular Edema Following Retinal Vein Occlusion (RVO) and Retinopathy of Prematurity (ROP).
- Eylea is significantly more expensive than Avastin. One injection of Eylea costs around $2000 compared to $100 for an injection of Avastin. One injection of Eylea HD costs around $2600.
- One retrospective analysis (Cao et al, 2022) reported that people administered Eylea were almost 3 times more likely to be weaned off treatment (also known as a treatment holiday) due to eye stabilization than those treated with Avastin (43% vs. 15% respectively). However, the study was not randomized nor blinded and could be subject to inherent bias that could have influenced the outcomes (for example, retina specialists holding the belief that Eylea is more potent).
Key Facts: Eylea Vs Avastin
Eylea | Eylea HD | Avastin | |
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Generic name | aflibercept | aflibercept | bevacizumab |
Company | Regeneron | Regeneron | Genentech |
FDA approval date | 2011 | 2023 |
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Generic availability | No generic | No generic | No generic |
Drug class | VEGF inhibitor (anti-angiogenic ophthalmic agent) | VEGF inhibitor (anti-angiogenic ophthalmic agent) | VEGF/VEGFR inhibitor |
Dosage form | Intravitreal injection | Intravitreal injection | Injection: 100 mg/4 mL (must be drawn up for intravitreal injection. Usual dose is 0.1ml [2.5mg]) |
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Common side effects (>5% of patients) |
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Related questions
References
- Yorston D. (2014). Intravitreal injection technique. Community eye health, 27(87), 47.
- Cao X, Castillo Sanchez J, Patel T, et al. Aflibercept is more effective than bevacizumab at weaning neovascular age-related macular degeneration patients off therapy
- Eylea HD. Prescribing Information. Updated Aug 28, 2023. https://www.drugs.com/pro/eylea-hd.html#s-34092-7
- Eylea. Updated Sep 1, 2022. Prescribing Information. https://www.drugs.com/pro/eylea.html
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