Vascular endothelial growth factor plasma levels before and after treatment of neovascular age-related macular degeneration with bevacizumab or ranibizumab
Vascular endothelial growth factor plasma levels before and after treatment of neovascular age-related macular degeneration with bevacizumab or ranibizumab
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DOI：
10.1111/j.1755-3768.2011.02240.x
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发表时间：
2012-02-01
影响因子：
3.4
通讯作者：
Soares, Raquel
中科院分区：
文献类型：
--
作者：
Carneiro, Angela M.;Costa, Raquel;Soares, Raquel
目的：目的：探讨玻璃体腔注射雷珠单抗（ranibizumab）和贝伐单抗（bevacizumab）对渗出型老年性黄斑变性（AMD）患者血浆血管内皮生长因子（VEGF）水平的影响。19例患者玻璃体内注射雷珠单抗0.5 mg，24例患者玻璃体内注射贝伐单抗1.25 mg。在第一次注射前和以4周间隔进行的三次初始连续注射后28天（负荷剂量）采集血样。结果：基线时，对照组VEGF浓度中位数为180.97 pg/ml，贝伐单抗组为189.72 pg/ml，雷珠单抗组为191.36 pg/ml。湿性AMD患者的VEGF血浆浓度与对照组相当（p = 0.225）。第三次注射后28天，发现贝伐珠单抗治疗患者的中位VEGF血浆水平显著降低42（109.97 pg/ml; p = 0.0002），但在接受雷珠单抗治疗的患者中未发现（189.97 pg/ml; p = 0.198），其中发现中值降低0.7%。玻璃体内注射贝伐单抗显著降低渗出性AMD患者的VEGF血浆水平，直至玻璃体内注射后28天。在相同时间点，雷珠单抗未实现显著的血浆VEGF降低。这些发现提示了玻璃体内给药后两种药物之间潜在的全身安全性差异。
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.