TY - JOUR
T1 - Evidence-Based Use of Bevacizumab in the Management of Neovascular Age-Related Macular Degeneration
AU - Singh, Rishi P.
AU - Avery, Robert L.
AU - Barakat, Mark R.
AU - Kim, Judy E.
AU - Kiss, Szilárd
N1 - Publisher Copyright:
© 2024 Singh, Avery, Barakat et al.
PY - 2024/3
Y1 - 2024/3
N2 - Indicated for colorectal cancer for decades, bevacizumab has been widely used off label to treat retinal diseases, and the benefits of its use, specifically in neovascular age-related macular degeneration, have been demonstrated in multiple clinical trials. The intravitreal delivery of bevacizumab requires it to be aseptically repackaged into individual syringes by compounding pharmacies for use in the eye. Although the repackaging process is permitted by the US Food and Drug Administration, the resultant product does not meet the specific standards of products approved for use as ophthalmic injectables nor is the parenteral innovator solution compliant with ophthalmic standards. Studies have also demonstrated variability in the quality and quantity of repackaged bevacizumab. This narrative review summarizes the evidence and discusses the role of off-label bevacizumab in the treatment and management of retinal diseases, its mechanism of action, current challenges and provides a critical appraisal of current evidence, clinical implications, and future directions.
AB - Indicated for colorectal cancer for decades, bevacizumab has been widely used off label to treat retinal diseases, and the benefits of its use, specifically in neovascular age-related macular degeneration, have been demonstrated in multiple clinical trials. The intravitreal delivery of bevacizumab requires it to be aseptically repackaged into individual syringes by compounding pharmacies for use in the eye. Although the repackaging process is permitted by the US Food and Drug Administration, the resultant product does not meet the specific standards of products approved for use as ophthalmic injectables nor is the parenteral innovator solution compliant with ophthalmic standards. Studies have also demonstrated variability in the quality and quantity of repackaged bevacizumab. This narrative review summarizes the evidence and discusses the role of off-label bevacizumab in the treatment and management of retinal diseases, its mechanism of action, current challenges and provides a critical appraisal of current evidence, clinical implications, and future directions.
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U2 - 10.3928/23258160-20240108-01
DO - 10.3928/23258160-20240108-01
M3 - Review article
C2 - 38466965
AN - SCOPUS:85187794434
SN - 2325-8160
VL - 55
SP - 156
EP - 162
JO - Ophthalmic Surgery Lasers and Imaging Retina
JF - Ophthalmic Surgery Lasers and Imaging Retina
IS - 3
ER -