Systemic Adverse Events Among Patients With Diabetes Treated With Intravitreal Anti–Vascular Endothelial Growth Factor Injections


Tags Retina
Journal JAMA Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

JAMA Ophthalmology Published online June 1, 2023








English Abstract

The study explores the systemic safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents among patients with diabetes. The authors aimed to assess the risk of systemic adverse events associated with intravitreal anti-VEGF therapy in patients with diabetes.

The study included a large cohort of 1,731,782 patients with type 2 diabetes. Data on incident systemic adverse events among this patient cohort were extracted from January 1, 2013, to December 31, 2017. The researchers evaluated the association between intravitreal anti-VEGF injections and the development of systemic adverse events while controlling for various factors such as age, sex, race, ethnicity, tobacco use, severity of diabetic retinopathy (DR), comorbidity burden, and other variables.

The results of the study indicated that intravitreal anti-VEGF therapy was independently associated with a higher likelihood of systemic adverse events, including acute myocardial infarction, cardiovascular disease, and kidney disease. Other factors that were associated with an increased risk of systemic adverse events included older age, male sex, tobacco use, non-White race, higher DR severity, and comorbidity burden.

The study highlights the importance of considering the systemic safety profile of intravitreal anti-VEGF agents in patients with diabetes. While previous studies have reported mixed results, this large cohort study provides valuable data from a clinical practice setting. The findings suggest that clinicians should be cautious when considering anti-VEGF therapy in patients with diabetes, especially those at higher risk for systemic adverse events.

It is important to note that this study has certain limitations, including its reliance on billing codes for diagnoses, potential inaccuracies in coding, and the lack of control for the duration of diabetes. Further research with larger sample sizes and longer follow-up periods is needed to confirm and better understand these findings.

Overall, this study contributes to the existing body of literature on the systemic safety of intravitreal anti-VEGF therapy in patients with diabetes and emphasizes the need for careful consideration of potential risks and benefits in clinical decision-making.