A safety review of drugs used for the treatment of retinopathy of prematurity

Expert Opin Drug Saf. 2020 Nov;19(11):1409-1418. doi: 10.1080/14740338.2020.1826927. Epub 2020 Sep 29.

Abstract

Introduction: Retinopathy of Prematurity (ROP) is a sight-threatening disease representing one of the main disabling diseases affecting premature newborns. Presently, ROP is treated by surgical interventions and drug therapies are limited to the off-label use of a little amount of molecules approved for other pathologies.

Areas covered: Many drugs that may potentially be used in treating ROP are recently proposed, in many cases after the demonstration of their effectiveness in preclinical studies. In this review, the authors discuss safety and effectiveness of the main proposed approaches in the pharmacologic treatment of the disease, including approaches based on oxygen therapy and nutritional interventions.

Expert opinion: Surgical approaches to ROP are not without side effects. However, most of the proposed pharmacologic interventions can also raise specific concerns. In particular, these approaches follow a curative paradigm and are proposed in patients once the disease has progressed, with an effectiveness that is often smaller than expected. A goal in the treatment of ROP would be moving the paradigm toward a preventive approach that could be potentially effective in treating extremely low birth weight preterm infants before ROP becomes manifest.

Keywords: Antioxidants; IGF-1; NSAIDs; VEGF; anti-VEGF; hyperoxia/hypoxia; propranolol; steroids.

Publication types

  • Review

MeSH terms

  • Animals
  • Humans
  • Infant, Extremely Low Birth Weight
  • Infant, Newborn
  • Infant, Premature
  • Nutritional Support
  • Off-Label Use
  • Oxygen / administration & dosage*
  • Retinopathy of Prematurity / pathology
  • Retinopathy of Prematurity / physiopathology
  • Retinopathy of Prematurity / therapy*

Substances

  • Oxygen