title: Arterial thromboembolic events in patients with exudative age-related macular degeneration treated with intravitreal bevacizumab or ranibizumab.
abstract: OBJECTIVE
  To compare retrospectively the incidence of arterial thromboembolic events (ATEs) in patients treated with bevacizumab or ranibizumab for exudative age-related macular degeneration.
  
  
  METHODS
  Charts of 378 patients treated with at least 1 intravitreal injection of ranibizumab or bevacizumab were reviewed to calculate the incidence of ATEs. Only patients under monotherapy were analyzed.
  
  
  RESULTS
  ATEs occurred in 15 patients: 12 (12/97) with bevacizumab (12.4%) and 3 (3/219) with ranibizumab (1.4%) - odds ratio 10.16; 95% confidence interval 2.80-36.93; p < 0.0001. ATEs in the bevacizumab and ranibizumab cohorts included stroke, myocardial infarction, angina pectoris, peripheral thromboembolic disease, transient ischemic attack, sudden death and lethal stroke.
  
  
  CONCLUSIONS
  In this series, bevacizumab raised the risk of ATEs when compared to ranibizumab. In an elderly population with multiple cardiovascular risk factors, the new ATEs may not be attributed exclusively to the intravitreal bevacizumab administration. These findings raise an issue that must be confirmed in randomized clinical trials.
authors.affiliation: Department of Ophthalmology, Hospital São João, University of Porto, Portugal. angelacarneiro @ netcabo.pt
authors.forename: Angela M
authors.initials: AM
authors.lastname: Carneiro
authors.forename: Daniel
authors.initials: D
authors.lastname: Barthelmes
authors.forename: Manuel S
authors.initials: MS
authors.lastname: Falcão
authors.forename: Luis S
authors.initials: LS
authors.lastname: Mendonça
authors.forename: Sofia L
authors.initials: SL
authors.lastname: Fonseca
authors.forename: Rita M
authors.initials: RM
authors.lastname: Gonçalves
authors.forename: Fernando
authors.initials: F
authors.lastname: Faria-Correia
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Falcão-Reis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008297:Male; D058729:Peripheral Arterial Disease / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D011174:Portugal / Q000453:epidemiology; D000069579:Ranibizumab; D012189:Retrospective Studies; D013923:Thromboembolism / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D057135:Wet Macular Degeneration / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D000069579:Ranibizumab