The effect of intravitreal bevacizumab (avastin) administration on systemic hypertension

Abstract

Aims To determine the short-term effect of intravitreal bevacizumab administration on systemic blood pressure levels of patients and to evaluate the safety of the drug in these patients. Methods Study population was divided into two groups: group A comprised patients who had hypertension and were under medication with antihypertensive drugs; group B comprised patients with normal blood pressure and were not under medication with antihypertensive drugs. All patients were graded according to their blood pressure levels before single dose of bevacizumab (0.05 ml; 1.25 mg) injection, and at day 1 and weeks 1, 3, and 6 thereafter. The blood pressure levels were analysed using repeated measures of analysis of variance (ANOVA). A P-value of o0.05 was considered significant.Results The study population included 82 patients with a mean age of 67.2±5.2 years. In group A, the systolic blood pressure levels showed significant increases at weeks 1, 3, and 6 (P ¼ 0.001, Po0.001, and P ¼ 0.003, respectively) compared with baseline. Similarly, diastolic blood pressure levels were significantly higher at weeks 3 (Po0.001) and 6 (P ¼ 0.016). In group B, the mean systolic and diastolic blood pressure levels showed significant elevations only at week 3 (P ¼ 0.004 and Po0.001, respectively). The percentages of both group A and B patients with normal blood pressure decreased at week 3 compared with baseline (Po0.001 and P ¼ 0.012 for groups A and B, respectively). Conclusions The findings of this study show that there is a risk of disregulation of blood pressure levels or persistence of hypertension in hypertensive patients after intravitreal bevacizumab injections.

Serum Concentration of Bevacizumab after Intravitreal Injection in Experimental Branch Retinal Vein Occlusion

“…In contrast to systemic applications, the intravitreal injection of bevacizumab was thought to be a safer procedure. There are several contradictory papers in the literature pointing out the potential risk of an increase in blood pressure following injection with bevacizumab [25][26][27] . Lee et al [24] showed that IVB is safe in terms of effects on blood pressure after 6 months of follow-up.…”

Papel do fator de crescimento vascular endotelial na angiogênese e na retinopatia diabética

“…Em decorrência da curta duração do seu efeito, os antiVEGFs necessitariam de injeções intravítreas repetidas, o que aumentaria o risco de endoftalmite, aumento da pressão intraocular, rasgo de epitélio pigmentar, rasgo e descolamento de retina. Apesar de ainda não ser bem investigado, em estudo recente foi observado aumento da pressão arterial nos pacientes normotensos e persistência da hipertensão em pacientes com HAS submetidos à injeção intravítrea de bevacizumabe (57).…”

Cardiac Issues of Noncardiac Drugs: The Rising Story of Avastin in Age-Related Macular Degeneration

“…A small population-based study, by Rasier et al [10], demonstrated that in patients with a history of treated hypertension, Avastin was associated with an 11.8/6.2-mm Hg increase in blood pressure 3 weeks after intravitreal injection (p < 0.001), and remained significantly elevated above baseline at 6 weeks of follow-up. Significant and sustained elevation over baseline was also seen in normotensive patients although to a lesser degree (approx.…”

“…Significant and sustained elevation over baseline was also seen in normotensive patients although to a lesser degree (approx. 5/4 mm Hg elevation, p < 0.001) [10]. Several studies published recently have further raised concerns within the ophthalmology community.…”