We agree that areas of uncertainty in the use of anti-VEGF agents to treat eye disease remain. To tackle uncertainty about dosing schedule for bevacizumab (Avastin), we are conducting a multicentre randomised trial in England. This study, the TANDEM trial, is a factorial trial comparing low dose with standard dose bevacizumab, and monthly with two monthly review schedules. The requirement for patients to be seen monthly for this common condition is taxing both to the health services and to the patients, most of whom are elderly. If a two monthly schedule is acceptable this would be a substantial advantage.

This issue is of such importance to the NHS, that the unusual step has been taken for a consortium of PCT commissioners in the East Midlands (the East Midlands Specialised Commissioning Group) to commission this trial.

Margaret S Childs (Trial Manager), Alexander Foss, Maria Koufali

Response to Anti-vascular endothelial growth factor treatment for eye diseases editorial, BMJ 2012;344:e2970

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