Neurodevelopmental outcomes of extremely preterm infants treated with bevacizumab for severe retinopathy of prematurity
CPS ePoster Library. Luu T. Jun 25, 2015; 99144
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Dr. Thuy Mai Luu
Dr. Thuy Mai Luu
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Abstract
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Background
Intravitreal injection of bevacizumab, a vascular endothelial growth factor inhibitor (VEGF), is used to treat retinopathy of prematurity (ROP). Because bevacizumab can escape into systemic circulation, potential long-term effect on brain development needs to be documented.
Objective
To compare 18-month neurodevelopmental outcomes at 18-22 months of preterm infants treated with bevacizumab versus laser/cryotherapy.
Methods
Data from the Canadian Neonatal Network and the Canadian Neonatal Follow-Up Network databases were retrospectively reviewed. A total of 125 infants born at <29 weeks gestational age (GA) in 2010-2011 with severe ROP requiring treatment and followed at 18-22 months corrected age (CA) were studied. Neurodevelopmental outcome was assessed using the Bayley Scales 3rd edition. Regression analyses were performed.
Results
Of the 125 infants, 27 had bevacizumab (GA 24.9±1.5 weeks, birth weight 739±172g) and 82 had laser (GA 24.7±1.3 weeks, birth weight 714±140g). Neonatal characteristics differed between the bevacizumab vs. laser therapy groups for male sex (60% vs. 42%), SNAP-II score (24 vs. 19), and late-onset sepsis (56% vs. 48%). Bevacizumab treated infants had lower motor scores than laser-treated infants (median 81 vs. 88, p=0.02), but comparable cognitive (median 90 vs. 90, p=0.46), and language scores (median 79 vs. 89, p=0.15). After adjusting for confounders, infants in the bevacizumab group were more likely to have severe neurodevelopmental impairment defined as severe cerebral palsy, deafness, blindness, or any Bayley score below 70 (OR 2.6; 1.00-6.83).
Conclusion
Preterm infants treated with bevacizumab had lower motor scores compared to those treated with laser therapy. There was no difference in cognition and language scores. Further investigation on the long-term safety of anti-VEGF treatment for ROP is needed.
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