Bevacizumab must be specially prepared for intraocular use

Torjesen clearly sums up the results of a recent trial showing that off-label use of bevacizumab (Avastin) is as effective as the more expensive licensed treatment for wet age related macular degeneration—ranibizumab (Lucentis).1 2 This will provide an effective treatment for people who cannot afford the more expensive drug.

However, the article did not mention that special techniques and precautions are needed when dividing and preserving bevacizumab for intraocular use. There are many ways to do this, and ophthalmologists should be aware that simply withdrawing bevacizumab from the vial and injecting it into the eye may not be safe.

In the IVAN 2 study, the pharmacy followed strict standard operating procedures and guidelines for preparing bevacizumab for intraocular use that were submitted to and approved by the UK Medicines and Healthcare Products Regulatory Agency.

This information is important because misconceptions about the use or misuse of bevacizumab could lead to serious complications, such as endophthalmitis, and could permanently affect patients’ vision. Such problems could also discourage ophthalmologists from using bevacizumab and also prevent authorities from approving the off-label use of this useful drug.