Bevacizumab Suppresses Pterygium-Associated Inflammation

Patients who received a subconjunctival injection of bevacizumab 1-week prior to ocular pterygium excision surgery exhibited effective suppression of pterygium-associated inflammation, according to findings published in the Journal of Taibah University Medical Sciences.

Patients (N=15) with clinically confirmed stage II primary pterygium were recruited at the Public Eye Center Makassar in Indonesia. Randomization occurred in a 1:1:1 ratio to receive a 2.5 mg bevacizumab (n=5), 20 mg triamcinolone (n=5), or placebo (n=5) subconjunctival injection 7 days prior to pterygium excision. Blood samples at the time of injection and 1 month after surgery were collected to assess for interleukin-1 (IL-1) levels.

Patients were aged between 30 and 45 years and were free from ocular surface diseases or infections, systemic diseases (eg, diabetes, hypertension, autoimmune disorders), and had not undergone previous ocular or pterygium surgeries.

At 1 month, mRNA IL-1 expression differed significantly from baseline (P =.036), in which bevacizumab recipients had the highest expression level (mean, 4.81; standard deviation [SD], 0.52) followed by triamcinolone (mean, 3.40; 9SD, 2.63) and placebo (mean, 1.08; SD, 1.48; P =.04).

Compared with placebo, bevacizumab caused a significant change to mRNA IL-1 expression (mean difference, 3.73; standard error [SE], 1.12; P =.00) but not triamcinolone (mean difference, 1.40; SE, 1.12; P =.06). There was no significant difference between the active treatment arms (mean difference, 2.33; SE, 1.12; P =.06).

The primary limitation of this study was the low sample size and the short study duration.

The study concludes that, due to the significant change in mRNA IL-1 expression among patients who received a subconjunctival injection of bevacizumab prior to pterygium excision surgery, this therapy was likely more effective than triamcinolone or placebo at reducing inflammation. These data combined with previous research which found that bevacizumab subconjunctival administration was effective at suppressing pterygium recurrence, makes bevacizumab an effective preoperative treatment for patients with pterygium.

Reference

Syawal P, Budu B, Hatta M, Massi MN, Ichsan AM, Minhajat R. Comparison between the triamcinolone and bevacizumab subconjunctivals and changes in Interleukin-1 mRNA expression in pterygium. J Taibah Univ Medical Sci. Published online August 16, 2021. doi:10.1016/j.jtumed.2021.07.009