Hypertension Associated With Bevacizumab

Intensified monitoring of circadian blood pressure and heart rate before and after intravitreous injection of bevacizumab: preliminary findings of a pilot study

“…Sane and colleagues also hypothesized that VEGF could affect the renin-angiotensin-system, particularly on receptors associated with angiotensin I and II [41]. Therefore, angiotensin-converting enzyme inhibitors have to be considered as an effective option in the management of hypertension associated with bevacizumab [42].…”

Hypertension Complicating Cancer Chemotherapy

“…At 5 mg/kg, hypertension occurred in 11% of patients, increasing to 28% at a dose of 10 mg/kg 9. According to the Avastin package insert (2004, Genentech, Inc., South San Francisco, CA), the incidence of hypertension using bevacizumab with 5‐fluorouracil regimes ranges from 60% to 67%, compared with 43% in control groups receiving 5‐fluorouracil regimes without bevacinimab 10. The patient presented in case 1 herein probably had stage 1 hypertension before developing a sustained hypertensive response to bevacizumab.…”

“…Bevacizumab is administered by IV infusion at 14‐day intervals. BP monitoring is recommended at least every 2–3 weeks, and for as long as 3 months following completion of therapy10 because of its long half‐life of approximately 20 days (range, 11–50 days). Bevacizumab should not be initiated in the setting of uncontrolled hypertension 11.…”

Understanding and managing the possible adverse effects associated with bevacizumab

“…lished to date, most patients with bevacizumab-associated hypertension have been managed with ACE inhibitors or calcium-channel blockers with noted success. 44,45 Rosiak and Sadowski 46 proposed that the JNC guidelines should be followed to treat elevated blood pressure in patients with bevacizumabassociated hypertension. These guidelines indicate that a thiazide diuretic should be first-line therapy, with other antihypertensive drugs added as second-line treatment if needed.…”