Monday, April 23, 2007

Avastin or Lucentis in Pregnancy

We received another question late last week:

Hi. I have a retinal lesion in each eye. The right one is fine, has been stable since July 2004, when both lesions were found. The right lesion was stopped by laser. My left eye, the lesion spread into my macula...laser treatments did not work. Macugen then came out and I had over a year of treatment with Macugen in my left eye. I haven't had a shot since August 2006, my left retina lesion has remained under control since then. However, I now have some leaking and I need a shot in left eye. I am pregnant, and I am asking as to whether you have heard of any other woman being pregnant getting a shot of Lucentis? My Retinal specialist has not, nor my OB-GYN....Thanks for your time.

I have heard of one pregnant woman who had an injection of Avastin for a choroidal neovascular membrane. I believe she was in her second trimester at the time. Her eye did fine and she had a completely normal baby. Keep in mind this is anecdotal evidence and not a controlled clinical study. I don’t think anyone knows the answer as to whether either of these drugs is safe in pregnancy. Genentech [http://www.fda.gov/cder/foi/label/2006/125156lbl.pdf] states that Lucentis should be given in pregnancy only if clearly needed. Pharmaceutical companies are very leery of litigation, so I think they would not have stated this if they thought there was more than a miniscule chance that the injection would hurt the mother or child.

I would like to know how good your vision was in the left eye before this flare-up. If you had poor vision anyway, you could consider waiting. If you’ve noticed worsening vision, then I think you should be treated and that you and your baby will do fine. I would recommend Lucentis rather than Avastin because of its shorter systemic half-life.

7 Comments:

Anonymous Anonymous said...

I am interested in learning more about this as well. I have choroidal osteoma with neovascularization and have been treated with lucentis x 5 months. My retinia doctor requires a negative pregnancy test prior to injections. Let me know how things go for you, because my DH and I would like to start a family, but feel limited due to the possible need for more injections. thanks!
kellyjmeyer@msn.com

6:59 AM  
Anonymous Anonymous said...

Hello,
I was quite interested to see the question on pregnancy. I am 17 weeks pregnant and have myopic macular degeneration in my left eye. My vision started a dramatic decline in my first trimester and my RS was only comfortable giving me a steroid shot. That actually caused significant improvement in my vision for about 6 weeks. Bleeding has started again (and vision is RAPIDLY declining) and I considered Lucentis but decided to go for a second steroid shot instead. It was a very difficult decision but when I realized that Thalidomide is an anti-angiogenic like Lucentis I became scared. I also read that these anti-growth agents TARGET areas that are growing... I'm not sure I made the right decision because I'm really scared about the negative impact of multiple steroid shots. And although, my RS was comfortable giving me the steroid I haven't been able to find any info on the safety to the fetus of an intraocular steroid injection during pregnancy.
Any further thoughts you have I'd love to hear.
Thanks so much.

11:38 PM  
Anonymous Anonymous said...

Hi there

I am also very interested in this topic - does anyone know if fluorescein is safe to use during pregnancy?

8:17 PM  
Blogger The Kutz Family said...

I have ocular histoplasmosis syndrome and I'm about 7 weeks pregnant. I've already lost my sight in the left eye to the disease and although I have active leaks, we aren't treating them b/c ther'es not much more damage they can do. But I had my first leak in my right eye last January and it took 3 Avastin shots to stop the leak. Currently, I've been leak free since June of 08.

I always have to sign a consent before I can have the fluorescein b/c they don't know how the dye will affect a growing baby. But I seldom have the Angio now. Just OCT.

I am VERY curious about having the injections while pregnant. We can't afford the Lucentis at $2k a pop but I was hoping that after my first trimester, it would be safe to have an Avastin if completely necessary. Please keep us updated with anything further you find!

Thanks!
Rebecca

9:28 AM  
Anonymous Anonymous said...

Is lucentis a steriod?

9:20 AM  
Anonymous Anonymous said...

Does anyone know id lucentis is safe while getting rituxan infusions?

9:21 AM  
Anonymous Anonymous said...

I am glad to see that I am not alone! My husband and I are trying to get pregnant and I have had to have numerous Avastin and now Lucentis injections. My RS always makes me sign a consent stating clearly that I am not pregnant. I am kind of nervous about getting pregnant and then having a flare up. Keep us posted on how you do.

8:03 PM  

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