Effect of intravitreal injection of aflibercept on blood coagulation parameters in patients with age-related macular degeneration

Constantinos D Georgakopoulos; Olga E Makri; Athina Pallikari; Konstantinos Kagkelaris; Panagiotis Plotas; Vasiliki Grammenou; Andreas Emmanuil

doi:10.1177/2515841420903929

Effect of intravitreal injection of aflibercept on blood coagulation parameters in patients with age-related macular degeneration

Ther Adv Ophthalmol. 2020 Feb 11:12:2515841420903929. doi: 10.1177/2515841420903929. eCollection 2020 Jan-Dec.

Authors

Constantinos D Georgakopoulos¹, Olga E Makri², Athina Pallikari², Konstantinos Kagkelaris², Panagiotis Plotas², Vasiliki Grammenou³, Andreas Emmanuil³

Affiliations

¹ Associate Professor of Ophthalmology, Department of Ophthalmology, Medical School, University of Patras, 265 04 Patras, Greece.
² Department of Ophthalmology, Medical School, University of Patras, Patras, Greece.
³ Department of Hematology, University Hospital of Patras, Patras, Greece.

Abstract

Purpose: Treatment with intravitreal injections of anti-vascular endothelial growth factor agents has been associated with an increased risk of arterial thromboembolic events. The aim of the present pilot study was to assess the effect of a single intravitreal injection of aflibercept on coagulation.

Methods: Treatment-naïve patients with age-related macular degeneration (n = 47), who were scheduled to undergo treatment with intravitreal injections of aflibercept, were enrolled. None of the included patients received any anticoagulation therapy or had a history of a recent arterial thromboembolic event. Blood samples were collected before the first intravitreal injection, and at 7 and 30 days after aflibercept administration. We evaluated coagulation parameters, such as platelet count and plasma fibrinogen and D-dimer levels; functional clotting parameters, such as prothrombin time, international normalized ratio, and activated partial thromboplastin time; and anticoagulant parameters, such as the levels of Proteins S and C.

Results: The levels of all of the evaluated biomarkers were within the normal range at baseline and at both the time points throughout the study. No statistically significant changes were observed in any of the measured parameters at 1 week and 1 month after aflibercept administration.

Conclusion: A single intravitreal injection of aflibercept in treatment-naïve patients with exudative age-related macular degeneration has no statistically significant effect on blood coagulation parameters for up to 1 month after aflibercept administration. Our results also provide an explorative statistical data, and further studies are required to evaluate any significant clinical effects of aflibercept on blood coagulation parameters.

Clinicaltrialsgov id: NCT03509623.

Keywords: Protein C; Protein S; activated partial thromboplastin time; aflibercept; age-related macular degeneration; arterial thromboembolic events; fibrinogen; international normalized ratio; plasma D-dimer; prothrombin time.

Associated data

ClinicalTrials.gov/NCT03509623