Safety of Intravitreal Bevacizumab Injection for Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema: A Systematic ReviewS. Sangroongruangsri and U. Chaikledkaew*
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Bevacizumab (IVB) has been widely used as an off-label treatment for treating neovascular age-related macular degeneration (nvAMD) and diabetic macular edema (DME) because its substantial lower cost than the approved drug named ranibizumab. However, there are concerns about possible serious adverse events (SAEs) of IVB particularly rare events and evidences supporting its safety profile remain inconclusive. This study aimed to examine serious ocular and systemic adverse events (AEs) of IVB in the treatments of nvAMD and DME. The articles were searched from Pubmed. Randomized controlled trials (RCTs), non-randomized studies, and prospective cohort studies, and case control study which reported SAEs of IVB compared with other anti-VEGF drugs in the treatment of nvAMD or DME were included. Studies which IVB were given in conjunction with other ocular procedures or therapies and articles published in non-English languages were excluded. Only 14 articles were included in this review. The incidences of endophthalmitis and arteriothrombotic events in nvAMD and DME patients were low. Although many studies concluded that the treatment with IVB was well-tolerated and had similar safety profile in patients with nvAMD and DME as comparing with IVR, pegaptanib, and different dosage regimen of IVB, this claim was opposed by a few studies. Large trials with longer follow up designed to detect particularly rare SAE are still required and it might be useful in treatment selection and decision making to allocate the resources for treatment of nvAMD and DME.
Keyword:
Intravitreal injection, Bevacizumab, Neovascular age-related macular degeneration, Diabetic macular edema, Adverse events
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