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Assessment group looks at PDT’s effects
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The magnitude of the beneficial effects of photodynamic therapy for different subgroups of patients with age-related macular degeneration has yet to be determined conclusively, according to an English group that undertook a technology assessment of PDT.
There has been considerable debate in the United Kingdom over the effectiveness of PDT and the need for the National Health System to reimburse for the procedure (click here for more on the subject). The national guidelines and reimbursement protocols for the procedure have yet to be finalized.
C. Meads and C. Hyde, of the University of Birmingham, England, reviewed the published literature on clinical effectiveness of PDT, specifically the two trials: the Treatment of Age-Related Macular Degeneration with PDT (TAP) study and the Verteporfin in PDT (VIP) study.
The two trials consistently showed that overall, PDT with verteporfin is more effective than placebo in slowing the rate of vision loss, the authors found. But they found some inconsistencies in the trials’ subgroup analyses.
In the TAP trials, 12 or more subgroup analyses were undertaken on the primary outcome measure, and in VIP, ten subgroup analyses on a subset of the participants were completed.
Results from the VIP trials indicated that verteporfin was equally effective in occult as in mixed lesions, whereas the TAP results indicated that verteporfin was more effective in the predominantly classic subgroup.
Results of the ongoing trials should help to clarify the issues of subgroup effects, the authors conclude. Their report is published in the February issue of British Journal of Ophthalmology.