Your browser doesn't support javascript.
loading
Risk of Intraocular Pressure Increase With Intravitreal Injections of Vascular Endothelial Growth Factor Inhibitors: A Cohort Study.
Spini, Andrea; Giometto, Sabrina; Donnini, Sandra; Posarelli, Matteo; Dotta, Francesco; Ziche, Marina; Tosi, Gian Marco; Girardi, Anna; Lucenteforte, Ersilia; Gini, Rosa; Etminan, Mahyar; Virgili, Gianni.
Afiliação
  • Spini A; From the Department of Medicine, Surgery and Neuroscience (A.S., F.D., M.Z., G.M.T.), University of Siena, Siena, Italy; Azienda Ospedaliera Universitaria Senese (A.S., M.P., F.D., G.M.T.), Siena, Italy.
  • Giometto S; Department of Clinical and Experimental Medicine (S.G., E.L.), University of Pisa, Pisa, Italy.
  • Donnini S; Department of Life Sciences (S.D.), University of Siena, Siena, Italy.
  • Posarelli M; Azienda Ospedaliera Universitaria Senese (A.S., M.P., F.D., G.M.T.), Siena, Italy.
  • Dotta F; From the Department of Medicine, Surgery and Neuroscience (A.S., F.D., M.Z., G.M.T.), University of Siena, Siena, Italy; Azienda Ospedaliera Universitaria Senese (A.S., M.P., F.D., G.M.T.), Siena, Italy.
  • Ziche M; From the Department of Medicine, Surgery and Neuroscience (A.S., F.D., M.Z., G.M.T.), University of Siena, Siena, Italy; Azienda Ospedaliera Universitaria Senese (A.S., M.P., F.D., G.M.T.), Siena, Italy.
  • Tosi GM; From the Department of Medicine, Surgery and Neuroscience (A.S., F.D., M.Z., G.M.T.), University of Siena, Siena, Italy.
  • Girardi A; Agenzia Regionale di Sanità della Toscana (A.G., R.G.), Firenze, Italy.
  • Lucenteforte E; Department of Clinical and Experimental Medicine (S.G., E.L.), University of Pisa, Pisa, Italy.
  • Gini R; Agenzia Regionale di Sanità della Toscana (A.G., R.G.), Firenze, Italy.
  • Etminan M; Departments of Ophthalmology and Visual Sciences and Medicine (M.E.), University of British Columbia, Vancouver, British Columbia, Canada.
  • Virgili G; Centre for Public Health (G.V.), Queen's University, Belfast, UK; Department NEUROFARBA (G.V.), University of Florence, Florence Italy. Electronic address: gianni.virgili@unifi.it.
Am J Ophthalmol ; 248: 45-50, 2023 04.
Article em En | MEDLINE | ID: mdl-36410468
PURPOSE: Intraocular pressure increase (IOPi) after intravitreal injections of vascular endothelial growth factor inhibitors (VEGFis) might be different among different VEGFis (bevacizumab, aflibercept, ranibizumab). The purpose of this study was to evaluate the risk of IOPi among new users of bevacizumab, ranibizumab, and aflibercept in nondiabetic patients in Tuscany, Italy. DESIGN: Retrospective cohort study. METHODS: Tuscan regional administrative database was used to identify subjects with a first VEGFi intravitreal injection between 2011 and 2020, followed to first incidence of IOPi. Diabetic subjects, those with pre-existing IOPi, or previous use of dexamethasone implants were excluded. Multivariable Cox regression analyses (intention-to-treat and as treated) were conducted to evaluate risk of IOPi among aflibercept, bevacizumab, and ranibizumab, adjusting for potential confounding variables. IOPi was defined as the first record of International Classification of Diseases, Ninth Revision (ICD-9-CM) code 365 or use of 2 glaucoma drugs dispensations within 180 days of each other. RESULTS: We identified 6585 new users of VEGFis: 1749 aflibercept, 1112 bevacizumab, and 3724 ranibizumab. Women made up 60% of the cohort, with a mean age of 73.6 years. In the intention-to-treat analysis, the adjusted hazard ratio (HR) for incident IOPi, compared with aflibercept, was higher for bevacizumab (HR = 2.20, 95% CI = 1.64-2.95) and ranibizumab users (HR = 1.88, 95% CI = 1.46-2.42), respectively. The HRs remained robust after exclusion of patients with proxy of retinal vascular occlusion. As treated analysis confirmed such results (bevacizumab: HR = 3.76, 95% CI = 2.30-6.17; ranibizumab: HR = 2.49, 95% CI = 1.62-3.82). CONCLUSIONS: This study found an increased risk of IOPi among nondiabetic patients with ranibizumab and bevacizumab compared with aflibercept. Future studies are needed to validate these findings.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glaucoma / Ranibizumab Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: Am J Ophthalmol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Itália País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glaucoma / Ranibizumab Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: Am J Ophthalmol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Itália País de publicação: Estados Unidos