Document Type
Article
Publication Date
11-1-2024
Abstract
PURPOSE: In individuals aged >50 years, age-related macular degeneration (AMD) is the leading cause of irreversible blindness. Intravitreal injections of antivascular endothelial growth factor (VEGF) agents (bevacizumab, ranibizumab, and aflibercept) show good efficacy and similar incidences of systemic adverse events (SAEs). However, comparative studies between agents are limited. Our study aimed to compare the real-world SAE risks of bevacizumab, ranibizumab, and aflibercept users.
METHODS: This retrospective cohort study identified new bevacizumab, ranibizumab, and aflibercept users in a multi-institutional database in Taiwan between 2014 and 2019. Inverse probability of treatment weights (IPTW) with propensity scores was conducted to achieve homogeneity among groups. The Fine and Gray model was utilized to estimate the subdistribution hazard ratio and 95% confidence interval.
RESULTS: This study included 701 bevacizumab, 463 ranibizumab, and 984 aflibercept users. After IPTW, all covariates were well-balanced. All three anti-VEGF agents had a low and comparable number per 100 person-years of major adverse cardiac events, heart failure, thromboembolic events, major bleeding, all-cause admission, and all-cause death (all P > 0.05). No significant differences in long-term change of systolic and diastolic blood pressure, low-density lipoprotein, estimated glomerular filtration rate, and alanine transaminase (all P for interaction > 0.05) were observed among groups.
CONCLUSION: Bevacizumab, ranibizumab, and aflibercept had a good systemic safety profile in this study. All groups showed a low and similar SAE risk and no differences in their long-term change of laboratory data. Therefore, these anti-VEGF agents could be prescribed safely to patients with AMD.
Recommended Citation
Lin, Tzu-Yi; Hsieh, Yi-Ting; Garg, Sunir J.; Chen, Lee-Jen; Chen, Kuan-Jen; Wu, Wei-Chi; Lai, Chi-Chun; Hwang, Yih-Shiou; and Kang, Eugene Yu-Chuan, "Systemic effects of anti-VEGF Intravitreal injection in Patients with Age-Related Macular Degeneration: A Multi-Institutional Real-World Study" (2024). Wills Eye Hospital Papers. Paper 238.
https://jdc.jefferson.edu/willsfp/238
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.
PubMed ID
39141487
Language
English
Included in
Chemicals and Drugs Commons, Eye Diseases Commons, Ophthalmology Commons, Therapeutics Commons
Comments
This article is the author's final published version in Indian journal of ophthalmology, Volume 72, Issue Suppl 5, November 2024, Pages S809 - S815.
The published version is available at https://doi.org/10.4103/IJO.IJO_3194_23.
Copyright © 2024 Indian Journal of Ophthalmology