Cardiac issues of noncardiac drugs: the rising story of avastin in age-related macular degeneration

Ophthalmologica. 2014;231(2):75-9. doi: 10.1159/000355569. Epub 2013 Nov 2.


Emerging safety data, accompanied with recent demographic trends, point to the need for an in-depth review and consideration of potential consequences that might arise from continuing use of bevacizumab (Avastin®) to treat elderly patients presenting with wet age-related macular degeneration (AMD). Although it is expected that lower doses of Avastin used for intravitreal administration and an intact blood-retina barrier would reduce the systemic exposure of the drug, both animal and human studies suggest that this may not be the case. In addition, emerging real-world and clinical trial data continue to point toward compromises in both cardio- and cerebrovascular safety with Avastin. Thus, clinicians are urged to adopt the highest possible standard of care in the treatment of an already fragile AMD population. Furthermore, postmarketing surveillance and pharmacovigilance with intravitreal anti-VEGF inhibitors should remain a priority.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage
  • Angiogenesis Inhibitors / pharmacokinetics
  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Antibodies, Monoclonal, Humanized / pharmacokinetics
  • Bevacizumab
  • Blood-Retinal Barrier*
  • Heart Diseases / complications
  • Heart Diseases / drug therapy*
  • Heart Diseases / metabolism
  • Humans
  • Intravitreal Injections
  • Macular Degeneration / complications
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / metabolism
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab