Intravitreal anti-VEGF injections linked to increased systemic adverse events in diabetic patients
Although intravitreal anti-VEGF injections are a widely used treatment for diabetic retinopathy (DR), they may be associated with an elevated risk of systemic adverse events, especially in high-risk patient groups, according to a new study published in JAMA Ophthalmology.
The study included 1,731,782 patients with type 2 diabetes seen at various Veterans Affairs healthcare facilities in the US. The study included both patients who received intravitreal anti-VEGF injections and those who did not, excluding only individuals with a history of prior systemic adverse events or those who had received such injections between January 2011 and December 2012.
Of the patients with type 2 diabetes, 27.5% (476,013) were diagnosed with DR, and only 0.8% (14,022) received anti-VEGF injections. The results revealed that during the 5-year follow-up period, 18.6% (321,940) of the entire cohort experienced systemic adverse events. The 5-year cumulative incidence of any systemic adverse event was significantly higher in the injection group, at 37.0% (5,187 out of 14,022), compared to 18.4% (316,753 out of 1,717,760) in the non-injection group (P < 0.001).
Even after controlling for various factors such as age, race, sex, ethnicity, tobacco use, severity of DR, Deyo-Charlson Comorbidity Index score, mean hemoglobin A1c, total number of injections, and statin use, the analysis found that anti-VEGF injections were independently associated with a higher likelihood of developing any systemic adverse event, with an odds ratio of 1.8 (95% CI, 1.7-1.9).
Zafar S, Walder A, Virani S, et al. Systemic Adverse Events Among Patients With Diabetes Treated With Intravitreal Anti–Vascular Endothelial Growth Factor Injections. JAMA Ophthalmol. Published online June 01, 2023. doi:10.1001/jamaophthalmol.2023.2098