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No greater risk for death seen with anti-VEGF vs. ablation for ROP

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NASHVILLE, Tenn. — There was no statistically significant difference in mortality in premature infants with retinopathy of prematurity treated with anti-VEGF or with retinal ablative therapy, according to a poster presented at the American Association for Pediatric Ophthalmology and Strabismus meeting.

“We undertook this study to address the possibility of increased death rate in premature infants that have been treated with anti-VEGF for ROP,” Iason S. Mantagos, MD, and colleagues from Boston Children’s Hospital wrote.

Of 127 premature infants treated for ROP, seven (5.5%) died of multifactorial causes. Of the seven who died, five had undergone retinal ablative therapy and two received primary or salvage intravitreal Avastin (bevacizumab, Genentech) treatment, an off-label use for this indication.

“It is known that more severe ROP is associated with increased morbidity and mortality,” the authors wrote.

There was a statistically significant difference (P < .001) in areas treated with the different modalities, with anti-VEGF being used more often in zone I or posterior zone II than was used in the retinal ablation group (55% vs. 21%).

Overall, 100 infants were treated with retinal ablative therapy, 19 with intravitreal bevacizumab and eight with a combination of the two. No infants in the combination treatment group died.

The major limitation of the study is lack of power, Mantagos told Healio.com/OSN.

“But at least it adds a piece of the puzzle of looking at the mortality rate in babies receiving intravitreal bevacizumab,” he said.

Further studies are needed to evaluate the risk for short- and long-term morbidity and mortality from the use of anti-VEGF agents for ROP treatment, the authors wrote. – by Patricia Nale, ELS

Reference:

Mantagos IS, et al. Mortality rate for premature infants treated for ROP with intravitreal anti-vascular endothelial growth factor (VEGF) medication vs. retinal ablative surgery. Poster 23 presented at: American Association for Pediatric Ophthalmology and Strabismus annual meeting; April 2-6, 2017; Nashville, Tenn.

Disclosure: Mantagos and colleagues report no relevant financial disclosures.