AUTHOR=Jiang Lin , Peng Liying , Zhou Yangzhong , Chen Gang , Zhao Bin , Li Mingxi , Li Xuemei 

TITLE=Do intravitreal anti-vascular endothelial growth factor agents lead to renal adverse events? A pharmacovigilance real-world study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1100397

DOI=10.3389/fmed.2023.1100397

ISSN=2296-858X

ABSTRACT=Purpose: Intraocular vascular endothelial growth factor (VEGF) blockade is essential in diabetic retinopathy (DR) treatment. However, it has been reported that intraocular VEGF treatment leads to deteriorated proteinuria and renal function. This study aimed to explore the relationship between renal adverse events and intraocular use of VEGF inhibitors.
Method: In the FDA’s Adverse Event Reporting System (FAERS) database, we searched for renal adverse event (AE) reports of patients receiving various commonly used VEGF blockers, and collected statistics on renal AE report data generated by different VEGF blockers. Case/non-case study of renal AE in patients treated with ranibizumab, aflibercept, bevacizumab, and pegaptanib (from January 2004 to June 2020) using disproportionate and Bayesian analysis. A case/non-case study was performed using disproportionality and Bayesian analysis. We also investigated the time to onset, fatality, and hospitalization rates of renal AEs.
Results: We identified 67 reports. Renal AEs were most frequently associated with ranibizumab (47.76%) and aflibercept (41.79%). However, the association between intraocular anti-VEGFs and renal AEs was insignificant, since the reporting odds ratio of aflibercept, bevacizumab, and ranibizumab were 0.29 (0.2, 0.42), 0.27 (0.13, 0.57) and 0.35 (0.25, 0.5), respectively. The median time to renal AEs onsets was 37.5 (interquartile range 7.25-180.5) days. The hospitalization rate and fatality rate in patients who developed renal AEs were 31.25% and 6.25%, respectively.
Conclusion: The risk of renal AEs in patients treated with intraocular anti-VEGFs needs more clinical evidence.