Role of Sub-Conjunctival Bevacizumab in Post Pterygium Excision Management

Pterygium Clinical Trial

Official title:

Role of Sub-Conjunctival Bevacizumab in Post Pterygium Excision Management

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01736449
• Other study ID #: IRB1108
• Status: Completed
• Phase: Phase 4
• First received: November 21, 2012
• Last updated: November 26, 2012
• Start date: April 2011
• Est. completion date: April 2012

Study information

• Verified date: November 2012
• Source: Arrowhead Regional Medical Center
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

A pterygium is a fibrovascular growth originating from the conjunctiva that grows onto the surface of the cornea. Frequently, these pterygia will recur even after surgical resection. Bevacizumab is an inhibitor of angiogenesis, which is needed for recurrent growth. The use of bevacizumab is poorly understood in inhibiting pterygium growth. The objective of this study is to compare the effects of wound healing and recurrence rates in postoperative bevacizumab versus pterygium excision alone.

Description:

This is a prospective trial. Thirty-one patients with a primary pterygium of at least 2 mm in size and without any previous ocular surgery will be included. Outcome measures will include best corrected visual acuity, intraocular pressure, recurrence, and any sight threatening complications at two weeks, two months, and six months postoperatively.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 31
• Est. completion date: April 2012
• Est. primary completion date: April 2012
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• any patient 18 years of age or older with a primary pterygium that extends at least 2 mm past the limbus

Exclusion Criteria:

• history of glaucoma

• previous ocular surgery

• steroid-response glaucoma

• previous myocardial infarct

• bleeding disorder

• pregnancy

• lack of patient cooperation

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Pterygium

Intervention

Drug:
• Bevacizumab

Locations

Country	Name	City	State
United States	Arrowhead Regional Medical Center	Colton	California

Sponsors (1)

Lead Sponsor	Collaborator
Arrowhead Regional Medical Center

Country where clinical trial is conducted

United States, 

References & Publications (21)

Ang LP, Chua JL, Tan DT. Current concepts and techniques in pterygium treatment. Curr Opin Ophthalmol. 2007 Jul;18(4):308-13. Review. — View Citation

Arevalo JF, Sanchez JG, Lasave AF, Wu L, Maia M, Bonafonte S, Brito M, Alezzandrini AA, Restrepo N, Berrocal MH, Saravia M, Farah ME, Fromow-Guerra J, Morales-Canton V. Intravitreal Bevacizumab (Avastin) for Diabetic Retinopathy: The 2010 GLADAOF Lecture. J Ophthalmol. 2011;2011:584238. doi: 10.1155/2011/584238. Epub 2011 Mar 30. — View Citation

Avisar R, Arnon A, Avisar E, Weinberger D. Primary pterygium recurrence time. Isr Med Assoc J. 2001 Nov;3(11):836-7. — View Citation

Banifatemi M, Razeghinejad MR, Hosseini H, Gholampour A. Bevacizumab and ocular wound healing after primary pterygium excision. J Ocul Pharmacol Ther. 2011 Feb;27(1):17-21. doi: 10.1089/jop.2010.0094. Epub 2010 Oct 26. — View Citation

Cortez RT, Ramirez G, Collet L, Thakuria P, Giuliari GP. Intravitreous bevacizumab injection: an experimental study in New Zealand white rabbits. Arch Ophthalmol. 2010 Jul;128(7):884-7. doi: 10.1001/archophthalmol.2010.139. — View Citation

Detorakis ET, Spandidos DA. Pathogenetic mechanisms and treatment options for ophthalmic pterygium: trends and perspectives (Review). Int J Mol Med. 2009 Apr;23(4):439-47. Review. — View Citation

Detorakis ET, Zaravinos A, Spandidos DA. Growth factor expression in ophthalmic pterygia and normal conjunctiva. Int J Mol Med. 2010 Apr;25(4):513-6. — View Citation

El-Batarny AM. Intravitreal bevacizumab treatment for retinal neovascularization and vitreous hemorrhage in proliferative diabetic retinopathy. Clin Ophthalmol. 2007 Jun;1(2):149-55. — View Citation

Enkvetchakul O, Thanathanee O, Rangsin R, Lekhanont K, Suwan-Apichon O. A randomized controlled trial of intralesional bevacizumab injection on primary pterygium: preliminary results. Cornea. 2011 Nov;30(11):1213-8. doi: 10.1097/ICO.0b013e31821c9b44. — View Citation

Fallah MR, Khosravi K, Hashemian MN, Beheshtnezhad AH, Rajabi MT, Gohari M. Efficacy of topical bevacizumab for inhibiting growth of impending recurrent pterygium. Curr Eye Res. 2010 Jan;35(1):17-22. doi: 10.3109/02713680903395273. — View Citation

Fallah Tafti MR, Khosravifard K, Mohammadpour M, Hashemian MN, Kiarudi MY. Efficacy of intralesional bevacizumab injection in decreasing pterygium size. Cornea. 2011 Feb;30(2):127-9. doi: 10.1097/ICO.0b013e3181e16d67. — View Citation

Ghazi NG, Kirk TQ, Knape RM, Tiedeman JS, Conway BP. Is monthly retreatment with intravitreal bevacizumab (Avastin) necessary in neovascular age-related macular degeneration? Clin Ophthalmol. 2010 Apr 26;4:307-14. — View Citation

Grisanti S, Ziemssen F. Bevacizumab: off-label use in ophthalmology. Indian J Ophthalmol. 2007 Nov-Dec;55(6):417-20. Review. — View Citation

Hirst LW. The treatment of pterygium. Surv Ophthalmol. 2003 Mar-Apr;48(2):145-80. Review. — View Citation

Lekhanont K, Patarakittam T, Thongphiew P, Suwan-apichon O, Hanutsaha P. Randomized controlled trial of subconjunctival bevacizumab injection in impending recurrent pterygium: a pilot study. Cornea. 2012 Feb;31(2):155-61. doi: 10.1097/ICO.0b013e3182151e0e. — View Citation

Manzano RP, Peyman GA, Khan P, Kivilcim M. Testing intravitreal toxicity of bevacizumab (Avastin). Retina. 2006 Mar;26(3):257-61. — View Citation

Michels S. Is intravitreal bevacizumab (Avastin) safe? Br J Ophthalmol. 2006 Nov;90(11):1333-4. — View Citation

Razeghinejad MR, Hosseini H, Ahmadi F, Rahat F, Eghbal H. Preliminary results of subconjunctival bevacizumab in primary pterygium excision. Ophthalmic Res. 2010;43(3):134-8. doi: 10.1159/000252980. Epub 2009 Oct 29. — View Citation

Shenasi A, Mousavi F, Shoa-Ahari S, Rahimi-Ardabili B, Fouladi RF. Subconjunctival bevacizumab immediately after excision of primary pterygium: the first clinical trial. Cornea. 2011 Nov;30(11):1219-22. doi: 10.1097/ICO.0b013e31820ca63f. — View Citation

Wong D, Joussen AM. The safety of using anti-VEGF: Is there strength in numbers? Curtis LH, Hammill BG, Schulman KA, Cousins SW (2010) Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration. Arch Ophthalmol 128(10):1273-1279. Graefes Arch Clin Exp Ophthalmol. 2011 Feb;249(2):161-2. doi: 10.1007/s00417-010-1603-7. Epub 2011 Jan 6. — View Citation

Yazdani S, Hendi K, Pakravan M. Intravitreal bevacizumab (Avastin) injection for neovascular glaucoma. J Glaucoma. 2007 Aug;16(5):437-9. — View Citation

* Note: There are 21 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	number of recurrent pterygia with postoperative bevacizumab	The number of recurrent pterygia with patients who received bevacizumab after pterygium excision was compared to the number of recurrences in those patients who only had pterygium excision.	6 months	No