A lower dose of intravitreal bevacizumab effectively treats retinopathy of prematurity

Khodabande, Alireza; Niyousha, Mohammad Reza; Roohipoor, Ramak

doi:10.1016/j.jaapos.2016.09.012

Cited by 8 publications

(3 citation statements)

References 18 publications

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“…Khodabande et al . showed 49 eyes with type 1 ROP treated with 0.25 mg/0.01 mL of IVB, and there was regression of plus disease/extraretinal neovascularization in all eyes during the first weeks after treatment and no recurrence of ROP in any eyes by 90 weeks gestation 24 . Hillier et al .…”

Section: Discussionmentioning

confidence: 89%

A lower dose of intravitreal conbercept effectively treats retinopathy of prematurity

Cheng

Meng

Linghu

et al. 2018

Sci Rep

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Intravitreal Conbercept (IVC) is the latest applied and effective treatment for the management of retinopathy of prematurity (ROP). However, conbercept escapes from the vitreous into the general circulation and reduce systemic VEGF concentrations. Thus, there are concerns about systemic complications, in these premature infants who are developing vital organ systems. This study is to determine whether a low dosage (0.15 mg/0.015 mL) of IVC is effective in the treatment of Zone II Stage 2/3 + ROP. A total of 38 eyes of 20 infants were analyzed retrospectively. We identified treatment effectiveness as complete regression of retinopathy and retinal vascularisation to zone III. The mean gestational age (GA), postmenstrual age (PMA) at treatment and birth weights (BW) were 28.6 ± 2.2 weeks, 39.3 ± 3.0 weeks and 1297.5 ± 429.2 g respectively. Primary effectiveness (react to IVC 0.15 mg alone) was found in 32/38 eyes (84.2%). Secondary effectiveness (a second IVC was required) was found in 6/38 eyes (15.8%). Follow-up continued until 90 weeks’ postmenstrual age and showed no recurrences of plus disease or neovascularization. The study suggests 0.15 mg IVC is effective for Zone II Stage 2/3 + ROP, and there is no adverse ocular outcomes during the follow-up period.

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Section: Discussionmentioning

confidence: 89%

A lower dose of intravitreal conbercept effectively treats retinopathy of prematurity

Cheng

Meng

Linghu

et al. 2018

Sci Rep

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“…Recently, it has become common practice in many neonatal intensive care nurseries to treat severe retinopathy of prematurity (ROP) by intravitreous injection of drugs blocking the bioactivity of vascular endothelial growth factor (VEGF). Bevacizumab is often used for this purpose, typically at doses of 0.25 mg to 0.625 mg, the latter being the dose that demonstrated efficacy in the Bevacizumab Eliminates the Angiogenic Threat of ROP (BEAT-ROP) trial . After intravitreous injection, bevacizumab is found in the systemic circulation and plasma VEGF levels decrease, so there are concerns about possible adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Short-term Outcomes After Very Low-Dose Intravitreous Bevacizumab for Retinopathy of Prematurity

et al. 2020

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IMPORTANCEIntravitreous bevacizumab (0.25 mg to 0.625 mg) is commonly used to treat type 1 retinopathy of prematurity (ROP), but there are concerns about systemic toxicity, particularly the risk of neurodevelopmental delay. A much lower dose may be effective for ROP while reducing systemic risk. Previously, after testing doses of 0.25 mg to 0.031 mg, doses as low as 0.031 mg were found to be effective in small cohorts of infants.OBJECTIVE To find the lowest dose of intravitreous bevacizumab effective for severe ROP.DESIGN, SETTING, AND PARTICIPANTS Between April 2017 and May 2019, 59 premature infants with type 1 ROP in 1 or both eyes were enrolled in a masked, multicenter, dose de-escalation study. In cohorts of 10 to 14 infants, 1 eye per infant received 0.016 mg, 0.008 mg, 0.004 mg, or 0.002 mg of intravitreous bevacizumab. Diluted bevacizumab was prepared by individual research pharmacies and delivered using 300-μL syringes with 5/16-inch, 30-guage fixed needles. Analysis began July 2019. INTERVENTIONSBevacizumab intravitreous injections at 0.016 mg, 0.008 mg, 0.004 mg, or 0.002 mg. MAIN OUTCOMES AND MEASURESSuccess was defined as improvement by 4 days postinjection and no recurrence of type 1 ROP or severe neovascularization requiring additional treatment within 4 weeks.RESULTS Fifty-five of 59 enrolled infants had 4-week outcomes completed; the mean (SD) birth weight was 664 (258) g, and the mean (SD) gestational age was 24.8 (1.6) weeks. A successful 4-week outcome was achieved for 13 of 13 eyes (100%) receiving 0.016 mg, 9 of 9 eyes (100%) receiving 0.008 mg, 9 of 10 eyes (90%) receiving 0.004 mg, but only 17 of 23 eyes (74%) receiving 0.002 mg.CONCLUSIONS AND RELEVANCE These data suggest that 0.004 mg may be the lowest dose of bevacizumab effective for ROP. Further investigation is warranted to confirm effectiveness of very low-dose intravitreous bevacizumab and its effect on plasma vascular endothelial growth factor levels and peripheral retinal vascularization.

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“…Lorenz et al 15 have reported more variable success in a retrospective study of 27 eyes treated with 0.312 mg IVB in 0.025 mL, with eight eyes (30%) requiring retreatment. More recently, Khodabande et al 16 have reported a prospective series of 49 eyes receiving IVB 0.25 mg/0.01 mL, followed up until 90 weeks’ PMA. They observed complete regression of ROP and no instances of recurrence during the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Ultra-low-dose intravitreal bevacizumab for the treatment of retinopathy of prematurity: a case series

2017

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A lower dose of intravitreal bevacizumab effectively treats retinopathy of prematurity

Cited by 8 publications

References 18 publications

A lower dose of intravitreal conbercept effectively treats retinopathy of prematurity

A lower dose of intravitreal conbercept effectively treats retinopathy of prematurity

Short-term Outcomes After Very Low-Dose Intravitreous Bevacizumab for Retinopathy of Prematurity

Ultra-low-dose intravitreal bevacizumab for the treatment of retinopathy of prematurity: a case series

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