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Rate of serious adverse effects in a series of bevacizumab and ranibizumab injections.

Abstract

OBJECTIVE
To compare the rate of serious ocular and systemic adverse effects of intravitreal bevacizumab and ranibizumab in the treatment of a variety of eye diseases.
DESIGN
Retrospective chart review.
PARTICIPANTS
Consecutive series of intravitreal injections of bevacizumab (n = 693) and ranibizumab (n = 891).
METHODS
Medical records of all patients receiving injections in the series were retrieved. We considered the rate of both serious ocular adverse effects (e.g., acute intraocular inflammation, infectious endophthalmitis, retinal detachment, vitreous hemorrhage) and of arterial thromboembolic events that occurred within 1 month of injection.
RESULTS
Subjects who received bevacizumab were 12 times more likely to develop severe intraocular inflammation following each injection than were those who received ranibizumab (OR = 11.71; 95% CI 1.5-93). The 1 case of acute intraocular inflammation following ranibizumab injection was mild and not associated with vision loss. No other serious ocular complications were noted. A trend was also noted toward an increased risk for arterial thromboembolic events in patients receiving bevacizumab, although the confidence interval was wide (OR = 4.26; 95% CI 0.44-41).
CONCLUSIONS
Significant concern still exists regarding the safety of off-label use of intravitreal bevacizumab. Patients receiving bevacizumab should be counselled regarding a possible increased risk for serious adverse events.

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  • Publisher Full Text

    • Authors

    Sharma S, Johnson D, Abouammoh M, Hollands S, Brissette A

    Institution

    Department of Ophthalmology, Queen's University, Kingston, Ont. sanjay_sharma60@hotmail.com

    Source

    Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 47:3 2012 Jun pg 275-9

    MeSH

    Aged
    Aged, 80 and over
    Angiogenesis Inhibitors
    Antibodies, Monoclonal, Humanized
    Endophthalmitis
    Female
    Humans
    Intravitreal Injections
    Macular Edema
    Male
    Middle Aged
    Retinal Detachment
    Retinal Vein Occlusion
    Retrospective Studies
    Risk Factors
    Thromboembolism
    Vascular Endothelial Growth Factor A
    Visual Acuity
    Vitreous Hemorrhage
    Wet Macular Degeneration

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22687306