Association between Cardiovascular Adverse Events With Intra
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A Study was conducted to evaluate systemic adverse events (SAEs) associated with intravitreal anti-VEGF drugs compared with non–anti-VEGF treatments in patients with ocular diseases. Randomized clinical trials conducted in adults with retinal diseases who received intravitreal anti-VEGF drugs.

Significant cardiovascular events (MACEs) and overall mortality were the primary outcomes. Nonocular hemorrhage, MACE materials, other cardiovascular outcomes, serious SAEs, and all SAEs were among the secondary outcomes.

Results:
--A total of 74 randomized clinical trials were analyzed: 32 trials (43%) included 14190 patients with age-related macular degeneration (AMD), 24 included 5424 patients with diabetic retinopathy (diabetic macular edema or proliferative diabetic retinopathy), 17 trials included 3757 patients with retinal vein occlusion, and 1 trial included 122 patients with myopic choroidal neovascularization.

--Anti-VEGF drug administration did not increase MACEs compared with control agents (odds ratio [OR], 1.16) or total mortality (OR, 1.27).

--There was an interaction in mortality risk depending on the underlying disease with an increase (OR, 1.80) in the risk of death in patients with diabetic retinopathy; however, no increase was observed in patients with AMD or retinal vein occlusion.

--Administration of anti-VEGF drugs increased the risk of nonocular hemorrhage (OR, 1.46), mainly in patients with AMD.

In conclusion, intravitreal anti-VEGF was not linked to an increase in MACEs. Increased mortality in diabetic patients and those with nonocular hemorrhages, especially in those with AMD, may be a warning sign.

Source: https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2778626
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