The news@nature.com overview of the AMD arena is somewhat superficial, IMO. I think it gives too much credence to the notion that one or more intravitreal drugs might win a slot in the standard of care as a “maintenance” therapy following initial treatment with Lucentis/Avastin.
My own opinion is that this will not happen; instead, I see three ways in which the AMD market could play out during the next five years:
1. Lucentis/Avastin monotherapy will retain a dominant market share; or
2. Some other monotherapy — perhaps VEGF-Trap or Sirna-027 — will rival or exceed Lucentis/Avastin in efficacy and capture a substantial share; or
3. No new drug will rival Lucentis/Avastin as a monotherapy, opening the door for an implant-based therapy such as the one offered by SRDX to be used in conjunction with Lucentis/Avastin.
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A corollary of the above is that the makers of VEGF-Trap, Sirna-027, and the other AMD drug candidates have to aim high, hoping to supplant Lucentis/Avastin as a monotherapy in a substantial fraction of patients. If these companies find that this goal is unrealistic, then they should pack it in.
This already happened with the ALNY/MRK AMD program and probably with several other early-stage AMD programs that were below investors’ radar screens.
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