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Title: Real-World Safety of Intravitreal Bevacizumab and Ranibizumab Treatments for Retinal Diseases in Thailand: A Prospective Observational Study
Authors: Sermsiri Sangroongruangsri
Usa Chaikledkaew
Suthasinee Kumluang
Olivia Wu
Claudia Geue
Tanapat Ratanapakorn
Pattara Leelahavarong
Lily Ingsrisawang
Paisan Ruamviboonsuk
Wongsiri Taweebanjongsin
Janejit Choovuthayakorn
Apichart Singalavanija
Prut Hanutsaha
Kittisak Kulvichit
Thitiporn Ratanapojnard
Warapat Wongsawad
Yot Teerawattananon
Chulalongkorn University
Rangsit University
Kasetsart University
Khon Kaen University
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Thailand Ministry of Public Health
Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Phramongkutklao College of Medicine
University of Glasgow
Chiang Mai University
Mettapracharak (Wat Rai Khing) Hospital
Keywords: Medicine
Issue Date: 1-Sep-2018
Citation: Clinical Drug Investigation. Vol.38, No.9 (2018), 853-865
Abstract: © 2018, The Author(s). Background: There is very limited evidence examining serious systemic adverse events (SSAEs) and post-injection endophthalmitis of intravitreal bevacizumab (IVB) and intravitreal ranibizumab (IVR) treatments in Thailand and low- and middle-income countries. Moreover, findings from the existing trials might have limited generalizability to certain populations and rare SSAEs. Objectives: This prospective observational study aimed to assess and compare the safety profiles of IVB and IVR in patients with retinal diseases in Thailand. Methods: Between 2013 and 2015, 6354 patients eligible for IVB or IVR were recruited from eight hospitals. Main outcomes measures were prevalence and risk of SSAEs, mortality, and endophthalmitis during the 6-month follow-up period. Results: In the IVB and IVR groups, 94 and 6% of patients participated, respectively. The rates of outcomes in the IVB group were slightly greater than in the IVR group. All-cause mortality rates in the IVB and IVR groups were 1.10 and 0.53%, respectively. Prevalence rates of endophthalmitis and non-fatal strokes in the IVB group were 0.04% of 16,421 injections and 0.27% of 5975 patients, respectively, whereas none of these events were identified in the IVR group. There were no differences between the two groups in the risks of mortality, arteriothrombotic events (ATE), and non-fatal heart failure (HF). Adjustment for potential confounding factors and selection bias using multivariable models for time-to-event outcomes and propensity scores did not alter the results. Conclusions: The rates of SAEs in both groups were low. The IVB and IVR treatments were not associated with significant risks of mortality, ATE, and non-fatal HF. Trial Registration: Thai Clinical Trial Registry identifier TCTR20141002001.
ISSN: 11791918
Appears in Collections:Scopus 2018

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