Statins for age-related macular degeneration: The jury is still out

May 4, 2005

HMGCoA reductase inhibitors (statins) have been evaluated in a small study with the hope that the agents will slow the progression of age-related macular degeneration (AMD). Results between the medication and placebo group were not significant at 12 months, but there were too few patients to reach definitive conclusions.

May 4

- Fort Lauderdale, FL - HMGCoA reductase inhibitors (statins) have been evaluated in a small study with the hope that the agents will slow the progression of age-related macular degeneration (AMD). Results between the medication and placebo group were not significant at 12 months, but there were too few patients to reach definitive conclusions.

Presently, there is no consensus about the role of statins in AMD. Study results thus far have been contradictory, according to R. Guymer, MD, who reported her results at the Association for Research in Vision and Ophthalmology. Some of the studies have suggested that statins have a protective effect in AMD, while other studies indicate no protective effect.

What is most interesting to Dr. Guymer is the possible anti-inflammatory effect that statins may have and the fact that these medications seem to inhibit complement activation; they also inhibit oxidation in low-density lipoprotein.

In a randomized pilot study conducted at the University of Melbourne, Australia, patients with bilateral high-risk AMD or one eye with end-stage AMD and the other with early AMD received either 40 mg of simvastatin or placebo for 3 years. Thus far, 85 patients have been enrolled. The primary end point was the development of late-stage AMD.

Twenty-nine of the patients on simvastatin and 21 in the placebo group have been followed for 12 months.

Dr. Guymer pointed out that because the numbers of patients were so small, no definitive conclusions could be drawn. The results so far show a significant drop in the cholesterol level of the patients on simvastatin. The visual acuity analysis of those who gained three lines of vision, lost three lines, or reached end-stage disease there was no statistical differences between the groups. There also was no difference in drusen scoring or visual function (rod, cone thresholds and adaptation).

"A randomized clinical trial is possible," she said. "It is important to continue to recruit and monitor patients at later time points to gain further valuable information regarding the effect of statins in AMD. We encourage others to try statins to inhibit AMD, because the drugs have been shown to be efficacious in other diseases."