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Potential safety concerns of Avastin for ROP considered
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BOSTON — There is increasing reason to consider potential safety concerns of Avastin therapy for retinopathy of prematurity, according to a speaker here.
Citing accumulating evidence, Robert Avery, MD, told colleagues at the American Society of Retina Specialists meeting that studies show there are systemic effects associated with the treatment.
“Since the BEAT-ROP study, there’s been a rapid advance in the widespread use of Avastin [bevacizumab, Genentech] for ROP, but I believe the systemic risk is a little underestimated,” Avery said, adding that he and others have shown that bevacizumab does penetrate the retina and enter the bloodstream where it reduces VEGF.
“Anti-VEGF agents have been quite helpful in ROP,” with results being more pronounced in the baby than in the adult and more so with bevacizumab than with ranibizumab (Lucentis, Genentech), Avery said.
Until more conclusive studies are done with regard to systemic effects of bevacizumab in ROP, though, Avery said that ranibizumab may be theoretically preferred over bevacizumab because ranibizumab offers two orders of magnitude less systemic exposure.
Furthermore, there are reports that lower doses of bevacizumab are effective. For example, Wallace and colleagues saw good results in babies on one-fortieth of the adult dose in a phase 1 dosing study. All nine babies in the study had reduced neovascularization at the low dose, Avery said.
“I think it’s reasonable to consider much lower doses in our current treatment of ROP,” he said. – by Patricia Nale, ELS
References:
Avery R. Potential safety concerns of bevacizumab for retinopathy of prematurity. Presented at: American Society of Retina Specialists 35th Annual Meeting, Aug. 11-15, 2017; Boston.
Wallace DK, et al. Assessment of lower doses of intravitreous bevacizumab for retinopathy of prematurity.
Disclosures: Avery reports he is a consultant for Allergan, Genentech, Novartis and Regeneron.