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怀孕期间静脉内抗血管内皮生长因子治疗:更新和当前的前景
Kevin X Zhang1, Curtis J Heisel1, Safa Rahmani1,2
1Department of Ophthalmology, Northwestern University Feinberg School of Medicine.
Current opinion in ophthalmology
|July 2, 2025
概括
在怀孕期间可以考虑使用抗糖尿病视网膜病变的抗静脉内皮生长因子 (抗VEGF) 药物. 目前的证据表明胎儿风险最小,但个性化治疗决定至关重要.
科学领域:
- 眼科医生 眼科 眼科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 糖尿病视网膜病变 (DR) 和糖尿病黄斑 (DME) 可以在怀孕期间恶化,威胁视力.
- 抗静脉内皮生长因子 (抗VEGF) 药物是非怀孕个体DR/DME的标准治疗方法.
- 由于对胎儿安全的担忧,孕妇使用抗VEGF药物的使用受到争议.
研究的目的:
- 审查有关怀孕期间使用抗VEGF药物的现有文献.
- 评估与怀孕期间抗VEGF治疗相关的孕产妇和胎儿结局.
- 将抗VEGF使用在早产视网膜病变 (ROP) 中的发现纳入.
主要方法:
- 对孕妇群体中抗VEGF药物的研究的文献综述.
- 对案例报告和回顾性研究的分析.
- 对接受ROP治疗的早产婴儿的长期结果的检查.
主要成果:
- 人类数据有限,但抗VEGF药物的系统吸收似乎很小.
- 对抗VEGF对胎儿血管生成的影响的担忧在很大程度上是理论上的.
- 关于ROP治疗的研究表明,与抗VEGF药物相关的不良神经发育结果没有.
结论:
- 孕妇患者不应该自动排除抗VEGF药物.
- 需要个性化治疗决策,平衡孕产妇和胎儿因素.
- 需要进一步的因果关系研究,以充分建立安全概况.
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