Systemic anti-VEGF shows benefits for wet AMD at 6 months

Retina. 2008;28(10):1375-1386.

Short-term data from a prospective cohort study showed no difference in visual acuity, optical coherence tomography and angiographic improvements in patients treated for wet age-related macular degeneration with either 2.5 mg/kg or 5 mg/kg of systemic bevacizumab.

At 3 months, visual acuity improved by 10 letters compared with baseline in eight patients treated with 5 mg/kg of intravenous Avastin (bevacizumab, Genentech) and by nine letters in eight patients treated with 2.5 mg/kg of bevacizumab. Central retinal thickness was reduced by 128 µm and 127 µm in the 5 mg/kg and 2.5 mg/kg groups, respectively. These results were still consistent at 6 months.

"Although no serious adverse events were identified and only a mild and not significant increase of [systolic blood pressure] was found, the study was too small to assess overall safety," the study said.

Systemic treatment may be preferable to intravitreal treatment because there is less need for re-treatment and intravenous delivery may be safer than intravitreal delivery. There is also the potential to treat bilateral AMD simultaneously.