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Trial to examine intravitreal bevacizumab for ROP management
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KIAWAH ISLAND, S.C. — An ongoing clinical trial will attempt to answer whether intravitreal bevacizumab is a better alternative to laser therapy in management of retinopathy of prematurity.
Aside from the potential to inhibit neovascularization, the use of Avastin (bevacizumab, Genentech) may overcome some of the shortcomings of laser therapy, W. Lloyd Clark, MD, said at Kiawah Eye 2009.
Laser is difficult to perform through occluded media caused by corneal or lens opacities, he said, and bevacizumab pre-empts the use of general anesthesia. Initial results suggest that intravitreal bevacizumab may produce similar or better outcomes than laser surgery when combined with vitrectomy, as well as lower postoperative inflammation.
"We are very early in the use of intravitreal bevacizumab for ROP, but I think within the next 4 to 5 years, it will replace laser," Dr. Clark said.
Dr. Clark is monitoring the BEAT-ROP study, a prospective, randomized, multicenter, controlled clinical trial that will compare intravitreal bevacizumab and vitrectomy used as primary therapy with conventional laser therapy and vitrectomy in patients with either zone 1 or zone 2 ROP.
One potential roadblock to use of intravitreal bevacizumab in ROP is the risk of systemic complications. However, the role of bevacizumab may be hard to separate out in clinical trials given the backdrop of serious concomitant conditions secondary to premature birth, Dr. Clark said.
In addition, Dr. Clark said, given the serious disease course of ROP, the theoretical benefits of intravitreal bevacizumab outweigh the potential risks.
Kiawah Eye 2010 will be held May 13-15, 2010 at the Kiawah Island Golf Resort in South Carolina. Learn more at KiawahEye.com.