New treatment for Scottish diabetics will help prevent blindness

DIABETICS in Scotland will become the first patients in the UK to be offered a new treatment which experts believe can help prevent blindness.

The Scottish Medicines Consortium (SMC) yesterday approved the use of Lucentis, an eye injection containing the drug ranibizumab, which can stabilise vision and lead to significant improvements in sight for diabetic macula oedema (DMO) sufferers.

Last night experts described the SMC’s decision as the “most significant development in the treatment of the eye condition in 25 years.”

Until now many people with DMO faced the possibility of irreversible sight loss as treatment was limited to laser therapy, which only slowed down the rate of impairment and helped stabilise vision.

The laser therapy can also cause damage to the surrounding eye tissue due to its destructive nature.

DMO is one of the main causes of vision loss, although it only occurs in about 1 to 3 per cent of diabetics. There are approximately 4,000 DMO sufferers in Scotland.

An estimated 250,000 people in Scotland suffer from diabetes, although many more cases are believed to be undiagnosed.

It is estimated that sight loss costs the NHS and public sector around £194 million a year in Scotland.

DMO is caused by the leaking of fluid from the small blood vessels in the eye. The build-up of fluid causes swelling and thickening of the macula, in the centre of the eye, reducing vision.

Dr Peter Cackett, consultant ophthalmologist at the Princess Alexandra Eye Pavilion, in Edinburgh, said: “I think this is a momentous decision in ophthalmology care in Scotland.

“If left untreated, diabetic macular oedema can lead to permanent damage or even irreversible blindness, so the availability of ranibizumab, a treatment which has been shown in rigorous clinical trials to lead to significant improvements in vision, through NHS Scotland, is very much welcomed.

Lucentis eye injections, which cost around £740 each, are given monthly and administered to the eye while the patient is under local anaesthetic.

John Legg, director of the Royal National Institute of Blind People (RNIB) Scotland, said the new drug treatment offers “real hope” for many DMO sufferers.

“This is an important and long-awaited step forward in the treatment of this distressing condition,” he added.

“DMO is the leading cause of blindness among the working age population in Scotland, and can have a significant impact on many aspects of a person’s life, such as working, driving and socialising.

“Ranibizumab is a treatment which offers real hope for some patients, many of whom may otherwise lose their sight completely.”

Jane-Claire Judson, national director of Diabetes UK Scotland, added: “We are pleased that the decision from the Scottish Medicines Consortium to accept the revised submission for Lucentis will mean more people with diabetes will have a better opportunity to preserve and possibly improve their vision.

“We particularly welcome this decision as it will help to improve management of diabetes and decrease the risk of other devastating complications, which are expensive both in terms of human and economic costs.”

A number of charities, including Diabetes UK and the RNIB, have urged the UK government to make Lucentis available to patients in England and Wales after the National Institute for Health and Clinical Excellence (Nice), the equivalent body to the SMC, rejected it on cost grounds.

Andrew Dillon, chief executive of Nice, said the manufacturer, Novartis, had underestimated the price of the treatment.