Higher-dose bevacizumab tied to fewer retreatments in ROP patients

Use of ranibizumab and lower-dose bevacizumab results in a higher rate of retreatment as compared with higher-dose bevacizumab use in patients with retinopathy of prematurity (ROP) initially treated with antivascular endothelial growth factors (anti-VEGFs), a study has shown.

A team of investigators performed a multicentre, retrospective study of ROP patients treated with anti-VEGF injections from 2007 to 2021 at 16 sites in the US. They obtained data on demographics, birth characteristics, examination findings, type and dose of anti-VEGF treatment, retreatment rates, and time to retreatment. Retreatment rates were compared between bevacizumab and ranibizumab injections.

A total of 661 patients, including 873 eyes, had been identified. Forty eyes treated with laser before anti-VEGF injection and 266 retreated with laser at or beyond 8 weeks after the initial anti-VEGF treatment were excluded. The primary analysis included 567 eyes of 307 patients (63 percent male).

No significant differences in birthweight, gestational age, age at first injection, ROP stages, or number of involved clock hours were observed between the no retreatment and retreatment groups.

The retreatment group had a higher proportion of aggressive ROP (34 percent vs 18 percent; p<0.001) and larger percentage of zone 1 ROP (49 percent vs 34 percent; p=0.001) when compared to the no retreatment group.

Use of ranibizumab correlated with a higher retreatment rate than bevacizumab use (58 percent vs 37 percent; p<0.001), while specific doses of ranibizumab showed no association with the rate of retreatment (R2, 0.67; p=0.32).

Additionally, lower doses of bevacizumab correlated with higher retreatment rates than higher doses (R2, 0.84; p=0.01). A dose specific-trend was noted, with higher doses of bevacizumab trending toward lower retreatments.