Short-term effects of intravitreal ranibizumab and bevacizumab administration on 24-h ambulatory blood pressure monitoring recordings in normotensive patients with age-related macular degeneration

Abstract

PurposeTo evaluate effects of intravitreal ranibizumab and bevacizumab administration on ambulatory blood pressure monitoring (ABPM) recordings in normotensive patients with age-related macular degeneration (AMD).Patients and methodsA total of 72 patients (mean age: 61.8(6.2) years, 52.8% were females) diagnosed with AMD were included in this study as divided into ranibizumab (n=34) and bevacizumab (n=38) treatment groups. Twenty-four hour, nighttime, and daytime ABMP values for systolic and diastolic BP were recorded in study groups before and after the third intravitreal injection of ranibizumab or bevacizumab.ResultsRanibizumab injection had no impact on ABPM recordings and dipping status. In the bevacizumab group, increased daytime (129.0(6.6) vs 127.7(6.6) mm Hg, P=0.002) and nighttime systolic (116.9(7.5) vs 112.6(7.1) mmHg, p<0.001) BP and decreased daytime diastolic (80.1(6.5) vs 82.4(6.1)mm Hg, P=0.001) BP were noted in the post-injection period. Also, percentage of non-dippers was significantly increased from 5.3% at pre-injection to 28.9% (P=0.004) at the post-injection period.ConclusionIn conclusion, given that it has no significant impact on ABPM recordings and dipping status, in our study, intravitreal ranibizumab injection may be the better choice in the management of AMD.

Immediate changes in blood pressure during intravitreal anti-VEGF agents' applications in exudative age-related macular degeneration patients

“…High plasma anti-VEGF accumulation in patients treated with bevacizumab may be the reason for the increase in SABP. Sengul et al [17] compared the effects of two intravitreal agents on 24 h ambulatory blood pressure in normotensive patients with ARMD and reported similar results to our study that there was a significant increase in SBP in patients treated with bevacizumab.…”

Safety and clinical effectiveness of intravitreal administration of bevacizumab (Lumiere^&reg;) in patients with neovascular age‑related macular degeneration

“…It was observed that the average baseline IOP values kept stable up to the sixth month and only three occurrences of non-serious AEs associated with elevated IOP were reported. Furthermore, changes observed in blood pressure and heart rate were minor and non-clinically relevant throughout the follow-up period, which is consistent with the observations reported in another study (50).…”

Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration

“…Serial injections of anti-VEGF in nAMD patients can elevate intraocular pressure which in some cases may require glaucoma therapy [ 147 ], although the incidence of this is low [ 148 ]. Long term IVT bevacizumab may increase risk of developing hypertension [ 149 ]. There is also some evidence that IVT anti-VEGFs may carry risk for systemic adverse thromboembolic events [ 150 ], however other studies have not found a link [ 151 ].…”