Repeat injections of bevacizumab are well tolerated

October 1, 2007

Repeat intravitreal injections of bevacizumab (off-label Avastin) for diseases such as proliferative diabetic retinopathy (DR), diabetic macular oedema (DME), retinal vein occlusions and choroidal neovascularization (CNV) appear to be safe and well tolerated.

Repeat intravitreal injections of bevacizumab (off-label Avastin) for diseases such as proliferative diabetic retinopathy (DR), diabetic macular oedema (DME), retinal vein occlusions and choroidal neovascularization (CNV) appear to be safe and well tolerated, according to a report published in the August issue of Graefes Archive for Clinical and Experimental Ophthalmology.

Maria Ana Martínez-Castellanos and colleagues from the Pan American Collaborative Retina Group (PACORES), based at the Instituto de Cirugía Ocular, San José, Costa Rica injected 1,265 consecutive patients with bevacizumab between 1 September 2005 and 31 January 2006. The subjects were treated for various disease such as proliferative DR, DME, retinal vein occlusion and CNV of several aetiologies including age-related macular degeneration (AMD). Of these, 92 were excluded because they were lost to follow-up. Patients were examined at baseline and then monthly for a 12-month period.

A total of 4,303 injections were administered and all patients were followed-up for the whole 12-month period. Systemic adverse events were reported in 18 (1.5%) patients and these included seven (0.59%) cases of acute elevation of systemic blood pressure, six (0.5%) cerebrovascular accidents, five (0.4%) myocardial infarctions, two (0.17%) iliac artery aneurysms, two (0.17%) toe amputations and five (0.4%) deaths. Ocular complications included seven (0.16%) cases of bacterial endophthalmitis, seven (0.16%) tractional retinal detachments, four (0.09%) cases of uveitis and one (0.02%) case of rhegmatogenous retinal detachment and vitreous haemorrhage.

The PACORES groups concluded that, although longer follow-up is required, bevacizumab is generally safe and well tolerated during the first year of therapy.