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Anti-VEGF injections safe in patients taking systemic anticoagulants
Retina. 2010;30(9):1386-1389.
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Intravitreal anti-VEGF injection proved safe in systemically anticoagulated patients, a study found.
"Our findings suggest that the rate of hemorrhagic complications in patients systemically anticoagulated or those on platelet inhibitor therapy or [aspirin] is extremely low," the study authors said. "Given the risk associated with stopping these therapies, we recommend that patients continue their current therapeutic regimen without cessation in the setting of intravitreal injections."
The retrospective case series included 675 eyes of 520 patients who received 3,106 injections of Avastin (bevacizumab, Genentech) or Lucentis (ranibizumab, Genentech).
The patient group comprised 134 eyes of 104 patients who were on Coumadin (warfarin, Bristol-Myers Squibb) and received 548 anti-VEGF injections; 123 eyes of 90 patients who were on Plavix (clopidogrel bisulfate, Bristol-Myers Squibb/Sanofi Aventis) and received 523 anti-VEGF injections; and eight eyes of seven patients who were on Plavix and Coumadin and received 33 anti-VEGF injections. In addition, 410 eyes of 319 patients were part of the control group and were not systemically anticoagulated; they received 2,002 anti-VEGF injections. Patients on aspirin therapy received a total of 1,254 anti-VEGF injections.
Study data showed three non-hemorrhagic complications related to the 3,106 injections: uveitic glaucoma in the control group, endophthalmitis in the control group and iritis in the Coumadin group. No hemorrhagic complications were noted in the Coumadin, Plavix and aspirin groups.
"Our study is not without limitations," the authors said. "This includes the fact that this study was retrospective. Also, anticoagulant herbal supplements and international normalized ratio were not recorded."