No difference in kidney failure risk between three anti-VEGF agents for eye disease

Key Takeaways

  • A study found there is not a substantially different risk of kidney failure among three anti-VEGF medications used for eye disease. 
  • The results suggest that the risk of kidney failure need not be a factor when choosing an anti-VEGF drug for patients with diabetic eye disease. 

Anti-vascular endothelial growth factor (anti-VEGF) drugs, which block a signal protein produced by cells that stimulates the formation of blood vessels, are used to treat several eye diseases, including diabetic retinopathy, diabetic macular edema, age-related macular degeneration, and retinal vein occlusion. There has been speculation that ranibizumab poses a lower risk of kidney failure than other anti-VEGF drugs because it has fewer systemic side effects, says Cindy X. Cai, MD, of Wilmer Eye Institute at Johns Hopkins University in Baltimore, author of a new study published in Ophthalmology Retina assessing the link between anti-VEGF drugs and kidney failure.

Cai and colleagues analyzed data from over 240,000 adult patients with eye disease who received eye injections of anti-VEGF medications. They found that there was no substantially different relative risk for kidney failure among aflibercept (Eylea), ranibizumab (Lucentis), and bevacizumab (Avastin). Cai told MedPage Today, “Prior to this study, some of us were perhaps preferentially choosing ranibizumab over aflibercept in our patients with diabetes who are at high risk for having kidney failure. Now, we can let other factors guide our treatment.”

Brian L. VanderBeek, MD, MPH, of the Scheie Eye Institute at the University of Pennsylvania in Philadelphia, who wasn’t involved with the study, told MedPage Today that “very few studies can be definitive, but this study definitely enhances my confidence that there is no difference between medications with regard to kidney risk.” Regarding limitations, the researchers highlighted their reliance on electronic health record/claims data, and they noted that the data don’t include information about dosages.

Source: Randy Dotinga, MedPage Today, April 10, 2024; see source article