Bevacizumab for Retinopathy of Prematurity: 2-Year Neurodevelopmental Follow-up

Abstract

Objective This study aimed to determine whether infants who were treated with intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP) were at higher risk of death or neurodevelopmental impairment (NDI) when compared with infants who were not treated with IVB (Laser only). Study Design This retrospective study included 146 infants born from 2009 through 2016 with a birth weight (BW) <1,000 g, gestational age <27 weeks, and required ROP therapy. Death and NDI rates were assessed at 18 to 24 months' corrected age. Results Rates of death or severe NDI were 62 and 53% in the IVB (n = 61) and Laser only (n = 85) groups, respectively. This difference was not statistically different despite sample selection bias in treating growth-restricted infants with IVB, BW (median [IQR]) was 481 (420–583) versus 547 (473–640) g in IVB and Laser only groups, respectively, p = 0.003. The adjusted odds ratio and 95% confidence interval of death or severe NDI was 0.86 (0.33–2.20). Conclusion Bevacizumab therapy for ROP did not affect survival and neurodevelopment of extremely preterm infants. Key Points

A Network Meta-Analysis of Retreatment Rates following Bevacizumab, Ranibizumab, Aflibercept, and Laser for Retinopathy of Prematurity

“…The 30 included studies consisted of 4 RCTs and 26 retrospective consecutive cohorts (Table 1). 11 studies comparing bevacizumab with laser therapy, 6,24,[35][36][37][38][39][40][41][42][43] 6 studies comparing ranibizumab with laser, 10,44-48 5 studies comparing bevacizumab with ranibizumab, [53][54][55][56][57] 3 studies comparing bevacizumab, ranibizumab and laser, [50][51][52] 2 studies comparing aflibercept with laser, 12,49 1 study comparing ranibizumab and aflibercept, 58 1 study compared bevacizumab and aflibercept and 1 study compared bevacizumab, ranibizumab, aflibercept. 60 In total, these comprise 4686 eyes of 2408 infants that received primary treatment for ROP with bevacizumab (2081 eyes), ranibizumab (727 eyes), aflibercept (326 eyes), or laser (1552 eyes).…”

The Male to Female Ratio in Treatment-Warranted Retinopathy of Prematurity

“…A subgroup meta-analysis of 50 studies reporting birth weight, gestational age, and postconceptual age at first treatment attained a similar percentage of treated male infants (54% [95% CI, 52%-57%]) (Figure 2). The weighted means (SDs) of birth weight (1027.9 [296] g vs 954.8 [274.6] g; P = .21), gestational age (27.5 [1.9] weeks vs 27 [2.1] weeks; P = .22), and postconceptual age at first treatment (36 [2] weeks vs 35.3 [3.7] weeks; P = .26) were similar between male and female infants. National income level was not associated with treatment in both male (β = −0.19 [95% CI, −0.38 to 0.01]; P = .05) and female (β = 0.15 [95% CI, −0.05 to 0.34]; P = .14) sexes.…”

An insight into brown/beige adipose tissue whitening, a metabolic complication of obesity with the multifactorial origin

“…Bevacizumab, a recombinant humanized anti-vascular endothelial growth factor (VEGF) antibody, is trailed in retinopathy of premature infants ( 175 ). Although anti-VEGF agents are the first-line treatment for various angiogenesis-related retinal diseases, it is not clear how the anti-VEGF antibody can accelerate the risks of systemic complications after intravitreal injection in premature infants ( 176 ). A study by Jo et al.…”