Serious Childhood Disabilities, Including Cerebral Palsy, May Be Linked to Avastin Use in Preemies, According to Researchers

Bevacizumab (Avastin), a drug used in the treatment of retinopathy for premature babies (ROP), may be associated with serious disabilities in children, including cerebral palsy and hearing loss, according to the results of a study recently published in the journal Pediatrics titled “Neurodevelopmental Outcomes Following Bevacizumab Injections for Retinopathy of Prematurity.”

ROP, a condition that occurs in premature babies, causes abnormal blood vessels to grow in the retina, the layer of nerve tissue in the eye that enables us to see. This growth can cause the retina to detach from the back of the eye, leading to blindness. Laser photoablation of the avascular retina, a surgery that uses light or lasers to destroy tissues, is the standard of care for treatment of ROP, and it is highly successful.

Bevacizumab intravitreal injection, a vascular endothelial growth factor inhibitor, is also used to treat ROP. But concerns have been raised regarding its systemic absorption and effect on developing tissues, including the brain.

Julie Morin, M.D., from the Sainte-Justine University Hospital Center in Montreal, Canada, and colleagues compared the neurodevelopment at 18 months’ corrected age in 27 preterm infants of less than 29 weeks gestation treated with bevacizumab compared to laser surgery.

The results showed that infants treated with bevacizumab, compared to babies treated with laser surgery, obtained a median Bayley Scales of Infant and Toddler Development Third Edition motor composite score of 81 versus 88, a language composite score of 79 versus 89, and a cognitive score of 90 versus 90. Differences were detected on the motor score only.

However, the odds of severe neurodevelopmental disabilities were 3.1 times higher in infants treated with bevacizumab compared to laser, after adjustment for gestational age, gender, maternal education, Score for Neonatal Acute Physiology-II, bronchopulmonary dysplasia, sepsis, and severe brain injury.

The study emphasizes the importance of analyzing potential systemic effects of novel medications that are used in preterm infants in terms of health outcomes and organ development.

“Preterm infants treated with bevacizumab versus laser had higher odds of severe neurodevelopmental disabilities,” the research team wrote in their article. “Further investigation on the long-term safety of antivascular endothelial growth factor treatment of ROP is needed.”