Safety of intravitreal injection of ranibizumab in early pregnancy: a series of three cases

• Published in: Eye (London) Vol. 32; no. 4; pp. 830 - 832
• Main Authors: Fossum, P, Couret, C, Briend, B, Weber, M, Lagarce, L
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.04.2018; Nature Publishing Group
• Subjects: 692/699/3161/3175; 692/700/565/2194; Adult; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - adverse effects; Birth; Case Series; Cholestasis; Choroidal Neovascularization - drug therapy; Choroiditis; Female; Fetuses; Humans; Immunotherapy; Injection; Intravitreal Injections; Laboratory Medicine; Medicine; Medicine & Public Health; Menstruation; Monoclonal antibodies; Neonates; Ophthalmology; Patients; Pharmaceutical Sciences/Technology; Pregnancy; Pregnancy complications; Pregnancy Outcome; Ranibizumab - administration & dosage; Ranibizumab - adverse effects; Surgery; Surgical Oncology; Teratogenicity; Vascularization
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2017.305

Purpose Ranibizumab is used in the treatment of choroidal neovascularization (CNV). Although systemic exposure to ranibizumab is low after ocular administration, its mechanism of action must be regarded as potentially teratogenic and embryo-fetotoxic. Women are advised to wait 3 months after the last dose of treatment with ranibizumab before conceiving. Little is known about the fetal side-effects of this drug. Methods Three pregnant women were treated with ranibizumab. One patient had idiopathic CNV. Results After receiving injections at 10 and 21 weeks after her last menstrual period (LMP), she gave birth to a healthy child. The second patient had myopic choroidal neovascularization (mCNV) and was treated by a single injection at 17 weeks post LMP. She gave birth to a healthy child after an uneventful pregnancy. The third patient had CNV secondary to a punctuate inner choroiditis. The injection was performed at 8 weeks post LMP. This patient presented a cholestasis of pregnancy at 36 weeks post LMP and gave birth at 38 weeks post LMP to a child that did not present any malformations. Conclusions This case series describes three women who underwent intravitreal ranibizumab treatment during pregnancy without showing any obstetric, embryofetal or neonatal complications.