Thread by @DrAbdulRazak_MD

#Bevacizumab for #ROP Rx & Neurodevelopment thread

Delighted our #metaanalysis out today in @JPerinatology

Results indicate Neurodevelopment harm associated w/ Avastin Rx

@EBNEO @waseemoddin

nature.com/articles/s4137…

rdcu.be/cbRdK #FOAMneo

1/6

The idea started with a dialogue by a colleague ”We don’t do lasers, they are ancient, we do avastin - simple, easy, less recurrence.”

Me: “there are long term risks - right?”

Colleague: Na, it’s ok, we already accepted & moved 🤨

2/6

I thought it’s good idea to pursue a #Systematicreview as the evidence is sketchy & controversial but what really pushed me to do the review is👇

Avastin can fire the brain for 60 days (#staylong) by suppressing VEGF that is crucial for brain growth

3/6

is.gd/5BE9AN

So, we pursued with a #Systematicreview

P: Preterm with severe ROP
E: Bevacizumab, any dose
C: Laser or Cryo (excluded if received both laser and bevacizumab)
O: Neurodevelopment impairment, Cognitive impairment & Cerebral palsy are primary and others, defined explicitly

4/6

We found 13 studies (RCT=1, & non-RCT=12) and we meta-analyzed the outcomes matching our definitions 👇

Overall, babies exposed to Bevacizumab had

INCREASED Risk of cognitive impairment

&

LOWER #language and #cognitive scores (Bayley-3) were

5/6

Wrap up: Avastin associated w/ Neuro harm

Message: Suggest completed RCTs to followup their babies, + future RCTs to include neurodevelopment as outcome

Meanwhile, people switching to Avastin-“be careful” & people caring Avastin babies- follow them carefully & intervene early

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