Background Bevacizumab is a monoclonal antibody that binds vascular endothelial growth factor. It reduces angiogenesis and vascular permeability. In Italy it is approved for colorectal, lung, breast and renal cancer. In 2007, law 648/96 allowed bevacizumab to be used in exudative macular degeneration (MD) and neovascular glaucoma. In 2009 AIFA authorised its use in patients aged under 65 and in non-treatment naive patients aged over 65. Since 2010 bevacizumab can be used only in patients aged under 65.
Purpose To assess the effectiveness of intravitreal bevacizumab injection on visual acuity (VA) in patients with neovascular MD.
Materials and methods Between January 1, 2008 and September 30, 2011 The authors assessed 356 patients (179 females and 177 males) who were 69.7±1.22 years of age. 81 patients received a dose of 1.25 mg of bevacizumab three times a year, prepared by pharmacists from Avastin 100 mg in the Antineoplastic Drug Preparation Room. The other 275 patients received bevacizumab as needed. Patient changes in VA were evaluated monthly with a Snellen-equivalent method.
Results There were 245 age-related MD patients, of whom 77.4% showed stability of vision, 2.8% showed an improvement in VA and 19.8% had slightly worse acuity. There were 111 non-age-related MD patients, of whom 81.8% showed stability of vision, 9.5% showed an improvement in VA and 8.7% had slightly worse acuity. The VA scores of patients who were given bevacizumab quarterly or as needed were:
Conclusions Macular degeneration is the leading cause of irreversible vision loss in the industrialised world. Bevacizumab optimises vision-related quality of life because it immediately reduces the amount of fluid in or under the retina. In fact, in this analysis, it showed a beneficial effect in stabilising loss of visual acuity and in a few patients even led to an improvement.
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