Plasma levels of vascular endothelial growth factor and pigment epithelium-derived factor before and after intravitreal injection of bevacizumab

Matsuyama, Kayako; Ogata, Nahoko; Matsuoka, Masato; Wada, Mitsumasa; Takahashi, Kanji; Nishimura, Tetsuya

doi:10.1136/bjo.2008.156810

Cited by 128 publications

(106 citation statements)

References 26 publications

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“…Even if cataract surgery is not estimated as a major problem today, the increased risk of postoperative CME or endophthalmitis, especially in diabetic patients, should be considered. On the other hand, it is proven that bevacizumab, even if delivered in minimal vitreal concentrations, downregulates VEGF plasma levels 17 and may provoke cardiovascular events, 18,19 as diabetic patients are innately exposed to increased cardiovascular risk factors. The therapeutic mechanisms of the drugs and the retinal structures are comparable, but not identical.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab (Avastin) versus triamcinolone (Volon A) for treatment of diabetic macular edema: one-year results

Kriechbaum

Prager

Mylonas

et al. 2013

Eye

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Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab (Avastin) versus triamcinolone (Volon A) for treatment of diabetic macular edema: one-year results

Kriechbaum

Prager

Mylonas

et al. 2013

Eye

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“…Therefore, intraocular injections of bevacizumab can lower blood VEGF levels by up to 117-fold within 1 day and by 4-fold up to 1 month later, changes comparable to those achieved with intravenous therapy. 78,79 These findings raise the possibility that intravitreally administered bevacizumab may suppress baseline physiologic VEGF activity. Bevacizumab has also been detected in contralateral eyes after injections in rabbits and has been associated with the regression of contralateral proliferative diabetic retinopathy and iris neovascularization.…”

Section: Systemic Concernsmentioning

confidence: 99%

The Expanding Role of Vascular Endothelial Growth Factor Inhibitors in Ophthalmology

Stewart

2012

Mayo Clinic Proceedings

161

105

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Vascular endothelial growth factor (VEGF) plays an important role in both physiologic and pathologic angiogenesis and contributes to increased permeability across both the blood-retinal and blood-brain barriers. After 2 decades of extensive research into the VEGF families and receptors, specific molecules have been targeted for drug development, and several medications have received US Food and Drug Administration approval. Bevacizumab, a full-length antibody against VEGF approved for the intravenous treatment of advanced carcinomas, has been used extensively in ophthalmology for exudative age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, retinopathy of prematurity, and other chorioretinal vascular disorders. Pegaptanib and ranibizumab have been developed specifically for intraocular use, whereas the soon-to-be-introduced aflibercept (VEGF Trap-Eye) is moving through clinical trials for both intraocular and systemic use. Although these drugs exhibit excellent safety profiles, ocular and systemic complications, particularly thromboembolic events, remain a concern in patients receiving therapy. Patients experiencing adverse events that may be related to VEGF suppression should be carefully evaluated by both the ophthalmologist and the medical physician to reassess the need for intraocular therapy and explore the feasibility of changing medications. For this review a search of PubMed from January 1, 1985 through April 15, 2011, was performed using the following terms (or combination of terms): vascular endothelial growth factors, VEGF, age-related macular degeneration, diabetic retinopathy, retina vein occlusions, retinopathy of prematurity, intravitreal injections, bevacizumab, ranibizumab, and VEGF Trap. Studies were limited to those published in English. Other articles were identified from bibliographies of retrieved articles and archives of the author.

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“…It has been shown that bevacizumab significantly reduces systemic VEGF levels after intravitreal injection (Matsuyama et al 2010;Carneiro et al 2012;Chakravarthy et al 2012;Zehetner et al 2013). Aflibercept contains a Fc fragment like bevacizumab and therefore interacts with the neonatal Fc receptor (FcRn).…”

Section: Introductionmentioning

confidence: 99%

Systemic levels of vascular endothelial growth factor before and after intravitreal injection of aflibercept or ranibizumab in patients with age‐related macular degeneration: a randomised, prospective trial

Zehetner

Kralinger

Modi

et al. 2014

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate the changes of vascular endothelial growth factor (VEGF) plasma levels after intravitreal injections of aflibercept or ranibizumab in patients with exudative age-related macular degeneration (AMD). Methods: Thirty-eight patients with exudative AMD were included in this randomised, prospective study. Nineteen patients were randomised to treatment with intravitreal aflibercept (2.0 mg) and 19 to intravitreal ranibizumab (0.5 mg). The concentration of VEGF was measured by ELISA just before the injection, after 7 days and 1 month. Twenty-two age-and sex-matched healthy patients without chorioretinal diseases served as control. Results: The median baseline plasma VEGF concentration was 61.0 pg/ml in the control group, 43.0 pg/ml in the aflibercept group and 59.0 pg/ml in the ranibizumab group (p = 0.127). Seven days after intravitreal injection of aflibercept plasma levels were significantly reduced to values below the minimum detectable dose (MDD) in 17 of 19 patients (89.5%) resulting in a median VEGF concentration of <9 pg/ml (p < 0.001). The reduction persisted throughout 1 month with values below the MDD in 5 of 19 patients (26.3%) and a median measurement of 17.0 pg/ml (p < 0.001). In patients treated with ranibizumab no significant effects could be observed with a baseline VEGF of 59.0 pg/ml, 54.0 pg/ ml at 7 days (p = 0.776) and 58.5 pg/ml at 4 weeks of follow-up (p = 0.670). Conclusion: After intravitreal aflibercept injection, the systemic VEGF levels were significantly reduced throughout the observational period of 4 weeks. No significant systemic effects of intravitreal ranibizumab on plasma VEGF were observed.

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Plasma levels of vascular endothelial growth factor and pigment epithelium-derived factor before and after intravitreal injection of bevacizumab

Cited by 128 publications

References 26 publications

Intravitreal bevacizumab (Avastin) versus triamcinolone (Volon A) for treatment of diabetic macular edema: one-year results

Intravitreal bevacizumab (Avastin) versus triamcinolone (Volon A) for treatment of diabetic macular edema: one-year results

The Expanding Role of Vascular Endothelial Growth Factor Inhibitors in Ophthalmology

Systemic levels of vascular endothelial growth factor before and after intravitreal injection of aflibercept or ranibizumab in patients with age‐related macular degeneration: a randomised, prospective trial

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