Horizon: Not so clear

Even though Lucentis ranibizumab from Genentech Inc. is approved as a once-monthly treatment for wet age-related macular degeneration, doctors have tended to dose it less often - known as treatment "as needed" - to reduce both the cost of therapy and the number of intravitreal injections a patient gets. While results of last week's HORIZON study showed a loss of visual acuity for patients who switched from monthly injections to treatment as needed, the trial's design suggests the data are unlikely to cause a sea change in clinical practice.

HORIZON was an open-label, U.S. extension study that enrolled 853 patients from the treatment and control arms of a trio of two-year trials: MARINA, ANCHOR and FOCUS. The earlier trials used monthly dosing of Lucentis, sham injections or photodynamic therapy (PDT). HORIZON patients were treated with Lucentis as needed, based on the investigator's judgment...