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Article

The Association of Intravitreal Injections of Different Anti-Vascular Endothelial Growth Factor with Systemic Outcomes in Diabetic Patients

by
Eugene Yu-Chuan Kang
1,2,3,
Tzu-Yi Lin
2,4,
Sunir J. Garg
5,
Nan-Kai Wang
6,
Lee-Jen Chen
7,
Pei-Wei Huang
2,3,8,
Ming-Jen Chan
2,3,9,
Kuan-Jen Chen
1,2,
Wei-Chi Wu
1,2,
Chi-Chun Lai
2,10 and
Yih-Shiou Hwang
1,2,11,12,*
1
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
2
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
3
Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan 333, Taiwan
4
Department of Education, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
5
MidAtlantic Retina, The Retina Service of Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
6
Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY 10032, USA
7
Department of Ophthalmology, Mackay Memorial Hospital, Taipei 104, Taiwan
8
Department of Oncology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
9
Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
10
Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
11
Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung 412, Taiwan
12
Department of Ophthalmology, Xiamen Chang Gung Memorial Hospital, Xiamen 361000, China
 
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Author to whom correspondence should be addressed.
J. Pers. Med. 2023, 13(3), 544; https://doi.org/10.3390/jpm13030544
Submission received: 29 January 2023 / Revised: 12 March 2023 / Accepted: 15 March 2023 / Published: 18 March 2023
(This article belongs to the Section Personalized Therapy in Clinical Medicine)
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Abstract

This retrospective cohort study aimed to assess the systemic effects of three commonly available anti-vascular endothelial growth factor intravitreal injections in patients with diabetes, using data taken from a multi-institutional database in Taiwan. Patient data were sourced from the multi-institutional Chang Gung Research Database. Participants were divided into groups based on treatment with bevacizumab, ranibizumab, or aflibercept. Baseline characteristics were matched among the groups by the inverse probability of treatment weighting. The incidence rate of outcome events was calculated as the number of events divided by 100 person-years of follow-up. The cumulative incidence function was used to estimate the incidence rate of the outcome events among groups. The incidence of ischemic stroke was higher in the ranibizumab group than the bevacizumab and aflibercept groups (1.65, 0.92, and 0.61 per 100 person-years, respectively). The incidence of major adverse lower-limb events was higher in the bevacizumab group (2.95), followed by ranibizumab (2.00) and aflibercept (0.74). Major bleeding was relatively higher in bevacizumab (12.1) compared to ranibizumab (4.3) and aflibercept (3.8). All-cause death was higher for both bevacizumab (3.26) and aflibercept (2.61) when compared to ranibizumab (0.55), and all-cause admission was found to be highest with bevacizumab (58.6), followed by aflibercept (30.2), and ranibizumab (27.6). The bevacizumab group demonstrated a greater decrease in glycated hemoglobin compared to the baseline level (−0.33%). However, a few differences in the clinical condition between the groups were still observed after matching. In conclusion, this study suggests that different anti-vascular endothelial growth factor agents may be associated with various and differing systemic adverse events. The differences might also be attributed to differences in patient characteristics and clinical status.
Keywords: intravitreal injection; anti-vascular endothelial growth factor; systemic outcomes intravitreal injection; anti-vascular endothelial growth factor; systemic outcomes

Share and Cite

MDPI and ACS Style

Kang, E.Y.-C.; Lin, T.-Y.; Garg, S.J.; Wang, N.-K.; Chen, L.-J.; Huang, P.-W.; Chan, M.-J.; Chen, K.-J.; Wu, W.-C.; Lai, C.-C.; et al. The Association of Intravitreal Injections of Different Anti-Vascular Endothelial Growth Factor with Systemic Outcomes in Diabetic Patients. J. Pers. Med. 2023, 13, 544. https://doi.org/10.3390/jpm13030544

AMA Style

Kang EY-C, Lin T-Y, Garg SJ, Wang N-K, Chen L-J, Huang P-W, Chan M-J, Chen K-J, Wu W-C, Lai C-C, et al. The Association of Intravitreal Injections of Different Anti-Vascular Endothelial Growth Factor with Systemic Outcomes in Diabetic Patients. Journal of Personalized Medicine. 2023; 13(3):544. https://doi.org/10.3390/jpm13030544

Chicago/Turabian Style

Kang, Eugene Yu-Chuan, Tzu-Yi Lin, Sunir J. Garg, Nan-Kai Wang, Lee-Jen Chen, Pei-Wei Huang, Ming-Jen Chan, Kuan-Jen Chen, Wei-Chi Wu, Chi-Chun Lai, and et al. 2023. "The Association of Intravitreal Injections of Different Anti-Vascular Endothelial Growth Factor with Systemic Outcomes in Diabetic Patients" Journal of Personalized Medicine 13, no. 3: 544. https://doi.org/10.3390/jpm13030544

APA Style

Kang, E. Y.-C., Lin, T.-Y., Garg, S. J., Wang, N.-K., Chen, L.-J., Huang, P.-W., Chan, M.-J., Chen, K.-J., Wu, W.-C., Lai, C.-C., & Hwang, Y.-S. (2023). The Association of Intravitreal Injections of Different Anti-Vascular Endothelial Growth Factor with Systemic Outcomes in Diabetic Patients. Journal of Personalized Medicine, 13(3), 544. https://doi.org/10.3390/jpm13030544

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