Bevacizumab: a compassionate way of doing business?

Spratt, A; Ogunbowale, Lola; Franks, Wendy

doi:10.1038/sj.eye.6702776

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…20,21 Fifty consecutive adults with NVG in whom PRP was deemed ineffective or impossible by their managing medical retinal or vitreoretinal specialist were recruited following institutional review board and local research ethics committee approval. Patients with concurrent ocular infection, a clinically significant medical condition, or women lactating, pregnant, or of childbearing age who were not using reliable contraception were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

“…The study was a prospective, observational case series; a randomized placebo-controlled trial design was rejected because the dire natural history of refractory NVG leaves no room for the clinical equipoise required for ethical randomization. 20,21 Fifty consecutive adults with NVG in whom PRP was deemed ineffective or impossible by their managing medical retinal or vitreoretinal specialist were recruited following institutional review board and local research ethics committee approval. Patients with concurrent ocular infection, a clinically significant medical condition, or women lactating, pregnant, or of childbearing age who were not using reliable contraception were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

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Intravitreal Bevacizumab in Refractory Neovascular Glaucoma

Kotecha

Spratt²,

Ogunbowale³

et al. 2011

Arch Ophthalmol

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To examine the efficacy of intravitreal bevacizumab for pain relief in eyes with refractory neovascular glaucoma.Methods: In this prospective case series, 52 eyes with neovascular glaucoma were administered intravitreal bevacizumab, 1.25 mg, and monitored for 6 months. The primary outcome measure was change in subjective pain score. Intraocular pressure and iris neovascularization were evaluated at each visit. Surgical intervention for control of intraocular pressure was performed according to clinical need. Results: Forty-two patients (44 eyes) completed the 6-month follow-up. Subjective pain score was reduced significantly 1 week after intravitreal bevacizumab injection and lasted throughout the follow-up period (median [interquartile range]: baseline, 3 [0-6]; week 1, 1 [0-3]; month 1, 0 [0-1]; month 3, 0 [0-1]; and month 6, 0 [0-0]; Kruskal-Wallis 2 31.03; P Ͻ.001). A rapid, yet relatively transient, reduction in iris neovascularization was also noted (iris neovascularization grade at baseline, 4.0 [3-4]; week 1, 2.5 [1-4]; month 1, 2.0 [1-4]; month 3, 3.0 [2-4]; and month 6, 3.0 [2-4], 2 23.33;PϽ.001). Four eyes (8%) required more than 1 injection to facilitate further intraocular surgery.Conclusions: Intravitreal bevacizumab is a useful adjunct in the management of refractory neovascular glaucoma, producing rapid relief of pain. However, we found no evidence to suggest that intravitreal bevacizumab lowers intraocular pressure in eyes with angle closure; conventional medical, laser, and surgical treatment are still needed in these eyes.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Intravitreal Bevacizumab in Refractory Neovascular Glaucoma

Kotecha

Spratt²,

Ogunbowale³

et al. 2011

Arch Ophthalmol

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“…A mediados de 2007 algunos expertos plantearon si el uso de bevacizumab era un tratamiento «compasivo» o una manera de ganar dinero para los oftalmólogos que lo utilizan (11). Se trata de un fármaco cada vez más utilizado en oftalmología, pero todavía no autorizado.…”

Section: Introductionunclassified

Eficacia y seguridad de la inyección intravítrea de bevacizumab en el tratamiento del glaucoma neovascular: revisión sistemática

Martínez-Carpio¹,

Bonafonte-Marquez²,

Heredia-García³

et al. 2008

Arch Soc Esp Oftalmol

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RESUMENPropósito: Revisión sistemática sobre la eficacia y seguridad de la inyección intravítrea de bevacizumab (IVB) en el tratamiento del glaucoma neovascular (GNV). Se incluyen todos los trabajos originales publicados en Medline hasta agosto de 2008. Métodos: Búsqueda y selección de la información en Internet y Medline, validadas mediante el Índice Kappa (K). Estudio estadístico y clínico de los resultados en los trabajos seleccionados, uno a uno. Resultados: Se encuentran 26 artículos originales que analizan la eficacia y seguridad del procedimiento en casos únicos y en series cortas de casos. 24 de ellos se analizan conjuntamente, con un total de 127 ojos intervenidos. La eficacia calculada para casos difíciles es del 68,7%. Las recidivas en un seguimiento de 4,2 meses son del 18,6%. Todos los trabajos son posteriores a 2006 y ninguno cumple criterios de ensayo clínico aleatorizado. Las com-REVISIÓN ABSTRACT Purpose: Systematic review on efficacy and safety of intravitreal bevacizumab (IVB) in the treatment of neovascular glaucoma (NVG). All original papers published in Medline (prior to August 2008) were included. Methods: Search and selection of information on the internet and in Medline, validated by Kappa Index (K). Statistical and clinical study of the results in the selected articles on a one by one basis. Results: 26 original papers analyzed the efficacy and safety of the procedure in case reports and short series of cases (127 eyes). The efficacy calculated in the sample was 68.7% and the recurrence rate was 18.6% in 4.2 months of follow-up. All studies were after 2006 and none of them was a clinical randomized controlled assay. Ophthalmic complications were under 0.78% and no systemic complications were found. ARCH SOC ESP OFTALMOL 2008; 83: 579-588 MARTÍNEZ-CARPIO PA, et al. Palabras clave:Bevacizumab, avastin, inyección intravítrea, glaucoma neovascular, rubeosis iris, fotocoagulación láser, factores de crecimiento, revisión sistemática. Conclusions:The use of bevacizumab demonstrates that intravitreal injections may be effective and useful to manipulate growth factors in the anterior chamber. IVB could serve as a first line treatment for NVG. Clinical trials are needed to confirm these results before its use is authorized (Arch Soc Esp Oftalmol 2008; 83: 579-588).

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Bevacizumab: a compassionate way of doing business?

Cited by 2 publications

References 4 publications

Intravitreal Bevacizumab in Refractory Neovascular Glaucoma

Intravitreal Bevacizumab in Refractory Neovascular Glaucoma

Eficacia y seguridad de la inyección intravítrea de bevacizumab en el tratamiento del glaucoma neovascular: revisión sistemática

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