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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Darlow, Brian A. Ells, Anna L. Gilbert, Clare E. Gole, Glen A. Quinn, Graham E. |
| Description | Country affiliation: New Zealand Author Affiliation: Darlow BA ( Department of Paediatrics, Christchurch School of Medicine and Health Sciences, University of Otago Christchurch, PO Box 4345, Christchurch 8140, New Zealand. brian.darlow@otago.ac.nz) |
| Abstract | The publication of the BEAT-ROP study of bevacizumab (Avastin) treatment for Zone I and II retinopathy of prematurity (ROP) has raised hopes that there might now be a simpler, cheaper and more effective treatment than laser therapy, the current standard of care. However, we would urge caution at this point in time. We review the scientific background to the use of intravitreal anti-vascular endothelial growth factor for ROP, highlight a number of design issues in the BEAT-ROP study and problems with interpretation of the results. For example, no visual outcomes were reported and the study was underpowered to assess longer term safety. Intravitreal bevacizumab leaks into the systemic circulation in animals and adult humans and there are real concerns of potential harm to the developing preterm infant because vascular growth factors play a critical role in organogenesis. We conclude that bevacizumab should be reserved for exceptional circumstances and compassionate use pending further studies. Laser remains the proven effective therapy for first line treatment of all forms of ROP with little systemic morbidity. Neonatology and ophthalmology have an impressive record of conducting collaborative multicentre studies and we urgently need further rigorously designed, adequately powered randomised trials of anti-VEGF agents that evaluate visual outcomes as well as short and long term ocular and systemic safety. |
| File Format | HTM / HTML |
| ISSN | 13592998 |
| Issue Number | 2 |
| Volume Number | 98 |
| e-ISSN | 14682052 |
| Journal | Archives of Disease in Childhood - Fetal and Neonatal Edition |
| Language | English |
| Publisher | BMJ Publishing Group |
| Publisher Date | 2013-03-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Pediatrics Discipline Perinatology Angiogenesis Inhibitors Therapeutic Use Antibodies, Monoclonal, Humanized Retinopathy Of Prematurity Drug Therapy Administration & Dosage Adverse Effects Bevacizumab Humans Infant, Newborn Infant, Premature Intravitreal Injections Physiopathology Vascular Endothelial Growth Factor A Antagonists & Inhibitors Physiology Journal Article Review |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pediatrics, Perinatology and Child Health Obstetrics and Gynecology |
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