No Increase in Stroke with Anti-VEGF Tx for Eye Disorders

Study called ‘a nice demonstration of what we’ve known clinically’

  • by Molly Walker, Staff Writer, MedPage Today
 BOSTON — Incidence of stroke did not increase among patients receiving anti-VEGF therapy compared with matched controls, researchers reported here.

A retrospective chart review found a smaller portion of patients receiving intravitreal injections with anti-VEGF agents suffered a stroke compared with a group of matched controls who did not receive the same therapies, reported Sophie Jane Bakri, MD, of the Mayo Clinic in Rochester, Minn., and colleagues.

 “There’s conflicting data regarding the association between anti-VEGF therapies and stroke, but no studies have performed a detailed examination of the types of strokes seen in patients on these therapies,” Bakri said at a presentation at the American Society of Retina Specialists annual meeting. She added that comparative trials for the approval of a new drug often do not have a control group.

Bakri’s group performed a retrospective chart review of patient health records in the Rochester Epidemiology Project, which is a validated healthcare database for Olmstead County in Minnesota. From 2004 to 2013, all patients who received anti-VEGF therapy for age-related macular degeneration, diabetic macular edema, proliferative diabetic retinopathy, and retinal vein occlusion were matched to several cohorts of age- and sex-matched controls composed of:

  • Same diseases in the pre-anti-VEGF era (1990-2003)
  • Same diseases in concurrent time period, but did not receive anti-VEGF therapy

Of the 2,541 patients, 690 received intravitreal injections with anti-VEGF agents. About 60% were women with a mean age of 74 and three-quarters of them had age-related macular degeneration. Mean follow-up ranged from 4.4 years in the study group to 9.7 years in the pre-anti-VEGF group.
Not surprisingly, these patients had a variety of preexisting conditions. Nearly all had hypertension, 50% had coronary artery disease, 40% had diabetes mellitus, and 30% had atrial fibrillation.
Bakri said there was “some difference” in the proportion of patients with hypertension, hyperlipidemia, coronary heart disease and atrial fibrillation between the study group and the controls. Patients in the study group had a higher use of disease-controlling drugs, including more patients on newer forms of anticoagulants….
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Source: Med Page Today