Drug-related adverse effects of antivascular endothelial growth factor agents

Prashanth G Iyer1, Thomas A Albini

  • 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.

Abstract

Insights

Newer anti-vascular endothelial growth factor (VEGF) drugs like brolucizumab and abicipar may cause severe adverse events, including intraocular inflammation and retinal vasculitis, not seen with established VEGF agents.

Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Pharmacology

Background:

  • Anti-vascular endothelial growth factor (VEGF) agents are crucial for treating retinal diseases.
  • Emerging anti-VEGF therapies require thorough understanding of their safety profiles.
  • Systemic and ocular adverse effects must be evaluated for patient management.

Purpose of the Study:

  • To review adverse effects of established anti-VEGF agents (bevacizumab, ranibizumab, aflibercept).
  • To highlight adverse effects of newer anti-VEGF agents (brolucizumab, abicipar).
  • To compare safety profiles of routine versus novel anti-VEGF therapies.

Main Methods:

  • Literature review of recent findings on anti-VEGF agents.
  • Analysis of intraocular inflammation (IOI) associated with brolucizumab and abicipar.
  • Comparison of adverse events with established anti-VEGF medications.

Main Results:

  • Brolucizumab is associated with occlusive retinal vasculitis, a novel finding in the context of IOI.
  • Abicipar demonstrates a higher incidence of IOI compared to previously reported rates for other anti-VEGF agents.
  • Newer agents present unique safety concerns not observed with routine therapies.

Conclusions:

  • Novel anti-VEGF agents introduce significant risks of adverse events.
  • These risks, including severe intraocular inflammation and vasculitis, differ from those of established anti-VEGF treatments.
  • Careful patient monitoring is essential when using newer anti-VEGF medications.

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