Vascular endothelial growth factor plasma levels before and after treatment of neovascular age-related macular degeneration with bevacizumab or ranibizumab

Ângela M. Carneiro*, Raquel Costa, Manuel S. Falcão, Daniel Barthelmes, Luis S. Mendonça, Sofia L. Fonseca, Rita Gonçalves, Conceição Gonçalves, Fernando M. Falcão-Reis, Raquel Soares

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

115 Citations (Scopus)

Abstract

Purpose: To evaluate the changes of vascular endothelial growth factor (VEGF) plasma levels after intravitreal injections of ranibizumab or bevacizumab in patients with exudative age-related macular degeneration (AMD). Methods: Forty-three patients with exudative AMD and 19 age- and sex-matched control patients without chorioretinal diseases were studied. Nineteen patients were treated with intravitreal ranibizumab 0.5 mg, 24 with intravitreal bevacizumab 1.25 mg. Blood samples were collected just before the first injection, and 28 days after three initial consecutive injections performed in 4-weekly intervals (loading dose). Concentration of VEGF in the plasma was measured by ELISA. Results: At baseline, the median VEGF concentrations in controls were 180.97 pg/ml, in the bevacizumab group 189.72 pg/ml and in the ranibizumab group 191.36 pg/ml. VEGF plasma concentrations in patients with wet AMD were comparable to controls (p = 0.225). Twenty-eight days after the third injection, a significant reduction of 42% in the median VEGF plasma levels was found in bevacizumab-treated patients (109.97 pg/ml; p = 0.0002) but not in ranibizumab-treated patients (189.97 pg/ml; p = 0.198) where a reduction of 0.7% in the median value was found. Conclusions: Intravitreal bevacizumab significantly reduced VEGF plasma levels until 28 days after intravitreal injection in patients with exudative AMD. Ranibizumab did not achieve a significant plasma VEGF reduction at the same time-point. These findings alert to the potential systemic safety differences between the two drugs after intravitreal administration.

Original languageEnglish
Pages (from-to)e25-e30
JournalActa Ophthalmologica
Volume90
Issue number1
DOIs
Publication statusPublished - Feb 2012
Externally publishedYes

Keywords

  • AMD
  • anti-VEGF therapy
  • Avastin®
  • Lucentis®
  • VEGF
  • wet AMD

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