Bevacizumab (Avastin) Eye Drops May Help Dry Eye Symptoms

 

Bevacizumab, (brand name Avastin) is a monoclonal antibody that functions as an angiogenesis inhibitor. inhibits vascular endothelial growth factor A (VEGF-A) and thus an anti–VEGF therapy or strong anti-inflammatory medication, It has been used to treat a number of types of cancers, (ie, colon cancer, lung cancer, glioblastoma, renal-cell carcinoma) and many eye diseases (ie, proliferative diabetic retinopathy; wet age-related macular degeneration when given by injection into the eye (intravitreal). 

^{It is now being investigated to help dry eye symptoms by decreasing inflammation.} 

^{Patients treated with bevacizumab 0.05% eye drops showed significant improvement in tear film stability, corneal staining and symptoms.}

^References: 

^1.
https://pubmed.ncbi.nlm.nih.gov/32502179/

They were instructed to use either 0.05% bevacizumab or placebo eye drops four times daily, together with preservative-free artificial tears (0.18% sodium hyaluronate) at least four times daily, in both eyes, and to keep all medications at 4 ˚C. Participants in both groups were also advised to instill the investigational or placebo eye drops for 12 weeks.

Efficacy of topical bevacizumab 0.05% eye drops in dry eye disease: A double-masked, randomized trial Ngamjit Kasetsuwan1,2*, Kanawat Chantaralawan1 , Usanee Reinprayoon1,2, Lita UthaithammaratID3 1 Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand, 2 Center of Excellence for Cornea and Stem Cell transplantation, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and Excellence Center for Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand, 3 Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand * Ngamjitk@gmail.com Abstract The objective of this double-masked, placebo-controlled, randomized trial was to assess the efficacy and safety of bevacizumab 0.05% eye drops in dry eye patients. This study included Dry Eye Workshop Study (DEWS) Grade 3–4 dry eye participants (n = 31) whose tear break-up time (TBUT) was �5 seconds(s). Participants were randomized to undergo treatment with either bevacizumab 0.05% eye drops (n = 19) or placebo (n = 12). The primary outcome was TBUT, and the proportion of responders (increase of �3s in TBUT at week 12), ocular surface disease index (OSDI) score, Schirmer test, and Oxford scheme grade were secondary outcomes. All outcomes were measured at 1-, 4- and 12 weeks. TBUT in bevacizumab group differed significantly from TBUT in placebo group within 12 weeks (P = 0.001). Moreover, the improvement of TBUT in bevacizumab group versus placebo group at 4- and 12 weeks differed significantly from that difference at baseline (P = 0.002 and P = 0.003, respectively). The proportion of participants achieving increase of 3 seconds or more of TBUT at week 12 in the bevacizumab group was significantly greater than that in the placebo group (P = 0.02). Oxford scheme grade at 1-, 4- and 12 weeks differed significantly from the values at baseline in bevacizumab group (P = 0.001, P = 0.01, and P = 0.03, respectively). OSDI scores at 1-, 4- and 12-week follow-ups were significantly lower than that at baseline in bevacizumab group (P<0.001 at each follow-up). Schirmer test were not significantly different within or between groups (the lowest P = 0.92). No adverse events occurred in this study. Patients treated with bevacizumab 0.05% eye drops showed significant improvement in tear film stability, corneal staining and symptoms.

2. 
https://pubmed.ncbi.nlm.nih.gov/17934753/
. 2008 Feb;246(2):281-4.
Bevacizumab (Avastin) eye drops inhibit corneal neovascularization
Felix Bock 1, Yanyan König, Friedrich Kruse, Martin Baier, Claus Cursiefen

• PMID: 17934753
 
• DOI: 10.1007/s00417-007-0684-4

Abstract
Background: To analyze the ability of bevacizumab (Avastin) eye drops to inhibit corneal neovascularization.
Design: interventional case series involving five patients (age: 42 +/- 14 years).
Methods: Patients with aggressive corneal neovascularisation not responding to conventional therapy were treated with bevacizumab (Avastin) eye drops (5x/day; 5 mg/ml) for 0.5 to 6 months (mean: 3.6 +/- 2; four patients with limbal stem cell deficiency [three due to chemical burns and one inherited] and one after perforating keratoplasty).
Results: Bevacizumab eye drops were well tolerated without obvious corneal side-effects. All five patients showed a reduction in the neovascularized area (decrease 48 +/- 28%; 13-75%).
Conclusions: Bevacizumab eye drops seem to inhibit corneal neovascularization without obvious corneal epithelial side-effects.

 doi: 10.1007/s00417-007-0684-4. Epub 2007 Oct 13.

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