The international intravitreal bevacizumab safety survey: Using the internet to assess drug safety worldwide

¹ Pacific Eye Associates, United States
² Bascom Palmer Eye Institute, United States
³ Tufts New England Eye Center, United States

^* To whom correspondence should be addressed. E-mail: annefungmd{at}yahoo.com.

Accepted 1 July 2006

	Abstract

Purpose: Off-label intravitreal injections of bevacizumab (Avastin) have been performed for the treatment of neovascular and exudative ocular diseases since May 2005. Since then, the use of intravitreal bevacizumab has spread worldwide, but the drug-related adverse events (AEs) associated with its use have only been reported in a few retrospective reviews. The International Intravitreal Bevacizumab Survey was initiated to gather timely information regarding adverse events from physicians around the world via the internet.

Methods: An internet based survey was designed to identify adverse events (AEs) associated with intravitreal bevacizumab therapy. The survey web address was disseminated to the international vitreoretinal community via email. Rates of AEs were calculated from participant responses.

Results: Seventy centers from 12 countries reported on 7,113 injections performed on 5,228 patients. Physician-reported AEs included corneal abrasion, lens Injury, endophthalmitis, retinal detachment, inflammation / uveitis, cataract progression, acute vision loss, central retinal artery occlusion, subretinal haemorrhage, retinal pigment epithelium tears, blood pressure elevation, transient ischemic attack, cerebrovascular accident and death. None of the AE rates exceeded 0.21%.

Conclusion: Intravitreal bevacizumab is being used globally for ocular diseases. Self-reporting of adverse events following intravitreal bevacizumab injections did not reveal an increased rate of potential drug-related ocular or systemic events. These short-term results suggest that intravitreal bevacizumab appears safe.

Keywords: bevacizumab, drug toxicity, internet, intravitreal, safety

Relevant Article

BJO at a glance

Creig Hoyt
Br. J. Ophthalmol. 2006 90: 1333. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				K. Ornek, Z. C. Karahan, A. Ergin, A. Tekeli, and O. Tekeli Bevacizumab Sterility in Multiple Doses from a Single-Use Vial Ann. Pharmacother., October 1, 2008; 42(10): 1425 - 1428. [Abstract] [Full Text] [PDF]

				A. C K Lee and J. Radford The ranibizumab saga of drug profiteering BMJ, September 3, 2008; 337(sep03_3): a1532 - a1532. [Full Text]

				L. Kong, H. A. Mintz-Hittner, R. L. Penland, F. L. Kretzer, and P. Chevez-Barrios Intravitreous Bevacizumab as Anti-Vascular Endothelial Growth Factor Therapy for Retinopathy of Prematurity: A Morphologic Study Arch Ophthalmol, August 1, 2008; 126(8): 1161 - 1163. [Full Text] [PDF]

				R. D. Jager, W. F. Mieler, and J. W. Miller Age-Related Macular Degeneration N. Engl. J. Med., June 12, 2008; 358(24): 2606 - 2617. [Full Text] [PDF]

				K Kriechbaum, S Michels, F Prager, M Georgopoulos, M Funk, W Geitzenauer, and U Schmidt-Erfurth Intravitreal Avastin for macular oedema secondary to retinal vein occlusion: a prospective study Br. J. Ophthalmol., April 1, 2008; 92(4): 518 - 522. [Abstract] [Full Text] [PDF]

				S J McGimpsey and M C Gillies Treatment of macular degeneration - controversy and hope Br. J. Ophthalmol., March 1, 2008; 92(3): 436 - 437. [Full Text] [PDF]

				T C Kreutzer, C S Alge, A H Wolf, D Kook, J Burger, R Strauss, C Kunze, C Haritoglou, A Kampik, and S Priglinger Intravitreal bevacizumab for the treatment of macular oedema secondary to branch retinal vein occlusion Br. J. Ophthalmol., March 1, 2008; 92(3): 351 - 355. [Abstract] [Full Text] [PDF]

				S V Goverdhan and J Lochhead Submacular haemorrhages after intravitreal bevacizumab for large occult choroidal neovascularisation in age-related macular degeneration Br. J. Ophthalmol., February 1, 2008; 92(2): 210 - 212. [Abstract] [Full Text] [PDF]

				Z. F. Bashshur, A. Schakal, R. N. Hamam, C. P. El Haibi, R. F. Jaafar, and B. N. Noureddin Intravitreal Bevacizumab vs Verteporfin Photodynamic Therapy for Neovascular Age-Related Macular Degeneration Arch Ophthalmol, October 1, 2007; 125(10): 1357 - 1361. [Abstract] [Full Text] [PDF]

				A view on new drugs for macular degeneration DTB, July 1, 2007; 45(7): 49 - 52. [Full Text] [PDF]

				C. H. Meyer, J. Callizo, S. Mennel, and A. Kussin Perioperative Management of Anticoagulated Patients Undergoing Repeated Intravitreal Injections Arch Ophthalmol, July 1, 2007; 125(7): 994 - 994. [Full Text] [PDF]

				R. P A Manzano, G. A Peyman, P. Khan, P. E Carvounis, M. Kivilcim, M. Ren, J. C Lake, and P. Chevez-Barrios Inhibition of experimental corneal neovascularisation by bevacizumab (Avastin) Br. J. Ophthalmol., June 1, 2007; 91(6): 804 - 807. [Abstract] [Full Text] [PDF]

				S K Gibran, A Sachdev, T Stappler, R Newsome, D Wong, and P Hiscott Histological findings of a choroidal neovascular membrane removed at the time of macular translocation in a patient previously treated with intravitreal bevacizumab treatment (Avastin) Br. J. Ophthalmol., May 1, 2007; 91(5): 602 - 604. [Abstract] [Full Text] [PDF]

				S. S Lynch and C. M Cheng Bevacizumab for Neovascular Ocular Diseases Ann. Pharmacother., April 1, 2007; 41(4): 614 - 625. [Abstract] [Full Text] [PDF]

				R B Bhisitkul Vascular endothelial growth factor biology: clinical implications for ocular treatments. Br. J. Ophthalmol., December 1, 2006; 90(12): 1542 - 1547. [Abstract] [Full Text] [PDF]

eLetters: