Weekly vaccination with Copaxone (glatiramer acetate) as a potential therapy for dry age-related macular degeneration.
OBJECTIVE
Drusen formation in age-related macular degeneration (AMD) shares some similarities with Alzheimer's disease (AD), which is associated with amyloid deposits. Aggregated beta-amyloid induces microglia to become cytotoxic and block neurogenesis. Recent evidence showed that T cell-based vaccination with Copaxone in AD mice model resulted in modulation of microglia into neuroprotective phenotype and as a result in reduction of cognitive decline, elimination of plaque formation, and induction of neuronal survival and neurogenesis. The aim was to investigate whether the effect of Copaxone on drusen in dry AMD is similar to that on deposits of other age-related chronic neurodegenerative diseases such as Alzheimer disease (AD).


METHODS
Patients over 50 years of age with intermediate dry AMD in both eyes were randomized to receive Copaxone or sham injections and were weekly treated by subcutaneous injections of Copaxone (dose of 20 mg) or sham injections for 12 weeks. At baseline, 6-week, and 12-week visits, visual acuity, contrast sensitivity, fundus examination and photography, fluorescein angiography, and ocular coherent tomography were performed. Main outcome measure was a change in total drusen area (TDA) measured by Image-Pro software and presented in arbitrary units (AU).


RESULTS
Eight studied eyes of four treated patients showed a decrease in TDA from 48130 to 16205 AU at 12 weeks as compared to baseline. In contrast, four control eyes (two patients) demonstrated almost no change in TDA (from 32294 to 32781 AU).


CONCLUSIONS
These preliminary results show that Copaxone reduces drusen area.
Landa
Gennady
G
Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel. doctor.landa@gmail.com
Butovsky
Oleg
O
Shoshani
Johai
J
Schwartz
Michal
M
Pollack
Ayala
A
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D000068717:Glatiramer Acetate; D006801:Humans; D007279:Injections, Subcutaneous; D008268:Macular Degeneration / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D010455:Peptides / Q000008:administration & dosage*; D010865:Pilot Projects; D015593:Retinal Drusen / Q000473:pathology / Q000628:therapy*; D014611:Vaccination
D000276:Adjuvants, Immunologic; D010455:Peptides; D000068717:Glatiramer Acetate