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Bevacizumab: off-label use in ophthalmology
Salvatore Grisanti1, Focke Ziemssen
1University Eye Hospital at the Centre of Ophthalmology, Eberhard-Karls University of Tuebingen, Germany. salvatore.grisanti@med.uni-tuebingen.de
Indian Journal of Ophthalmology
|October 24, 2007
Summary
Bevacizumab, an anti-vascular endothelial growth factor (VEGF-A) antibody, is used in ophthalmology for neovascular diseases. Despite its widespread use and cost-effectiveness, robust clinical trials are lacking to confirm its efficacy and safety for ocular conditions.
Area of Science:
- Ophthalmology
- Oncology
- Immunology
Background:
- Bevacizumab is a humanized monoclonal antibody targeting vascular endothelial growth factor-A (VEGF-A).
- Initially developed for solid tumors, it has been adopted for neovascular eye diseases.
- Over 100 publications document its use in ophthalmology since 2005.
Purpose of the Study:
- To review the existing literature on bevacizumab in ophthalmology.
- To assess the reported efficacy and safety of intraocular bevacizumab.
- To highlight the need for rigorous clinical trials.
Main Methods:
- Systematic literature search of PubMed up to April 2007.
- Independent assessment of research findings by two authors.
- Selection of key publications for review.
Main Results:
- Bevacizumab is widely used off-label in ophthalmology.
- Evidence for efficacy and safety is largely based on case reports and smaller studies.
- No well-designed randomized controlled trials (RCTs) currently exist for ocular indications.
Conclusions:
- Intraocular bevacizumab is considered a cost-effective VEGF inhibitor.
- Further well-designed RCTs are necessary to establish definitive efficacy and safety for ocular diseases.
- The current evidence base relies heavily on non-randomized data.
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