A Dosing Study of Bevacizumab for Retinopathy of Prematurity

Wallace, David K.; Dean, Trevano W.; Hartnett, M. Elizabeth; Kong, Lingkun; Smith, Lois E H; Hubbard, G. Baker; McGregor, Mary Lou; Jordan, Catherine O.; Mantagos, Iason S.; Bell, Edward F.; Kraker, Raymond T.

doi:10.1016/j.ophtha.2018.05.001

Cited by 103 publications

(86 citation statements)

References 27 publications

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“…Another study of 24 eyes with type 1 prethreshold ROP who received 0.1 mg of intravitreal ranibizumab showed regression of disease in all cases without any recurrence of disease or need for treatment at 54 weeks post-menstrual age 37. These findings coincide with dose de-escalation studies of bevacizumab for ROP, which found that dosing between 2.5% and 20% of the adult dose of bevacizumab may be effective in controlling acute ROP though these dose levels may lead to higher rates of recurrence 40,41…”

Section: Optimal Dose Of Ranibizumabsupporting

confidence: 81%

<p>Evidence to date: ranibizumab and its potential in the treatment of retinopathy of prematurity</p>

Patel

2019

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Retinopathy of prematurity (ROP) is a leading and preventable cause of childhood blindness worldwide. Although laser photocoagulation remains the gold standard for treatment, the off-label use of anti-vascular endothelial growth factor (anti-VEGF) therapy to treat ROP, particularly posterior zone I disease, is increasing. Although initial studies on anti-VEGF therapy for ROP have focused on bevacizumab, recent studies have proposed that ranibizumab may be a safer and more effective alternative for use in this population. This review updates recent evidence regarding the use of ranibizumab in the management of ROP.

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Section: Optimal Dose Of Ranibizumabsupporting

confidence: 81%

<p>Evidence to date: ranibizumab and its potential in the treatment of retinopathy of prematurity</p>

Patel

2019

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“…Wallace et al showed that a dose of bevacizumab as low as 0.031mg may be effective [30]. However, the author also reported that more patients receiving low-dose bevacizumab required additional treatment [31]. In addition, different anti-VEGF agents, for example ranibizumab and aflibercept, have demonstrated efficacy in treatment of type 1 ROP [27, 32].…”

Section: Discussionmentioning

confidence: 99%

Involution of retinopathy of prematurity and neurodevelopmental outcomes after intravitreal bevacizumab treatment

et al. 2019

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This single-centered, retrospective cohort study investigated the timing of involution of retinopathy of prematurity (ROP) and retinal vascularization to zone III after intravitreal bevacizumab (IVB) treatment and its possible impacts on postnatal growth and neurodevelopment. Premature infants with birth weight ≤1500 g, born between 2008 to 2014 and diagnosed with ROP were enrolled. All patients with type 1 ROP underwent IVB as 1st line treatment and were recruited as the study group; those with any stage of ROP except type 1 ROP without treatment served as controls. Neurodevelopmental outcomes were assessed using the Bayley Score of Infant Development (BSID) editions II or III. The study group included 35 eyes from 18 patients; the control group included 86 patients. Twenty-three eyes (65.7%) exhibited ROP regression after a single dose of IVB. The majority of plus sign and extraretinal neovascularization regressed within two weeks. The length of time for retinal vascularization to reach zone III was significantly longer in the treatment group compared with the control (mean post-menstruation age 54.5 vs. 47.0 weeks, p<0.001). Long-term follow-up showed no significant differences in body weight and neurodevelopment between the study and control groups up to the 2-year corrected age.

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“…It has been shown that a dosage of bevacizumab as low as 0.031 mg can be effective in ROP treatment, and further investigation into the optimal dosage is required, as are new assessments of the effectiveness and systemic safety of the treatment. [15] IVB monotheraphy might be a feasible option for the achievement of ROP regression with good anatomical outcomes. However, several cases of delayed reactivation have been reported with this method—sometimes as long as 3 years post-IVB treatment.…”

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confidence: 99%

The safety and effectiveness of 0.16 mg bevacizumab plus or minus additional laser photocoagulation in the treatment of retinopathy of prematurity

Akdogan

Çevik

Şahin

2019

Indian J Ophthalmol

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Purpose: Retinopathy of prematurity (ROP) is the leading cause of preventable blindness in premature infants. Antivascular endothelial growth factor (anti-VEGF) therapy has been used increasingly in treatment as a pharmacological alternative to laser therapy. In this study, we evaluate the results of low-dose anti-VEGF treatments. Methods: Design: Retrospective--observational study. Infants who had been evaluated for ROP disease between February 2016 and February 2017 were assessed. We retrospectively reviewed the ROP stages, treatment results, and complications. Laser photocoagulation (LPC) and intravitreal bevacizumab (0.16 mg IVB) were used for treatment and fundus fluorescein angiography (FFA) was also performed in some of the cases. Results: IVB was applied to 43 infants. A macular hole was seen in one infant's eye after IVB. LPC was applied to avascular areas in 21 infants. In three patients, persistence of the disease was observed after administration of a low dose of IVB. Additional LFK was performed in these patients. None of the infants who received LPC had any complications. Conclusion: IVB is increasingly becoming the first-line treatment for ROP. For severe ROP, 0.16 mg IVB is effective. Using LPC to treat avascular areas after 70 weeks’ gestational age (GA) may decrease the risk of late recurrence and appears to be a safe treatment to use.

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A Dosing Study of Bevacizumab for Retinopathy of Prematurity

Abstract: Retinal structural outcomes are very good after low-dose bevacizumab treatment for ROP, although many eyes received additional treatment.

Cited by 103 publications

References 27 publications

<p>Evidence to date: ranibizumab and its potential in the treatment of retinopathy of prematurity</p>

<p>Evidence to date: ranibizumab and its potential in the treatment of retinopathy of prematurity</p>

Involution of retinopathy of prematurity and neurodevelopmental outcomes after intravitreal bevacizumab treatment

The safety and effectiveness of 0.16 mg bevacizumab plus or minus additional laser photocoagulation in the treatment of retinopathy of prematurity

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