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Anti-VEGF Tx Seems OK for Eye Disorders

No increased risk of systemic adverse events with intravitreal anti-VEGF

by Kate Kneisel, Contributing Writer, MedPage Today

 Intravitreal anti-VEGF treatments for neovascular age-related macular degeneration (AMD), diabetic macular edema (DME), or retinal vein occlusion did not appear to increase the risk of systemic adverse events, particularly cardiovascular adverse events, French researchers found.

According to analysis of 21 systematic reviews and meta-analyses, intravitreal anti-VEGF was not associated with an increased risk of systemic adverse events (SAEs) when compared with control regimens, nor when treatment was given on a monthly schedule versus an as-needed regimen, according to Marie Thulliez, MD, of Bretonneau Hospital, in Tours, France, and colleagues.
However, caution might be advisable in older patients with AMD who may be at higher risk of hemorrhagic events when receiving ranibizumab, they wrote online in JAMA Ophthalmology.
The overview included studies with ranibizumab, bevacizumab, aflibercept, and pegaptanib published from Jan. 1, 2011 to June 30, 2016, with systemic adverse events the primary outcome in 11 and secondary outcome in 10. Ten reviews studied patients with AMD; six reviews studied patients with DME; and three reviews included patients with all 3 diseases and analyzed SAEs as the main outcome.
Ten reviews compared ranibizumab and a control regimen, while eight compared ranibizumab and bevacizumab, and five compared two or more anti-VEGF regimens with control treatment; others considered various dosing regimens.
Comparisons of bevacizumab and ranibizumab included only patients with AMD; one review linked bevacizumab with an increased risk of venous thrombotic events (RR 3.45, 95% CI 1.25-9.54) and four other reviews reported a lower range of relative risk (2.32 to 2.78) but with wide and nonsignificant confidence intervals, authors noted.
“Bevacizumab also increased the relative risk of SAEs by 20% to 35% in 3 reviews, but not in the most recent and most exhaustive Cochrane Review, which included unpublished data (RR 1.08, 95% CI 0.90-1.31).”…….
Read more: https://www.medpagetoday.com/ophthalmology/generalophthalmology/71990
Source: MedPage Today