June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Levels of systemic VEGF-A and ranibizumab in the infant of a nursing mother receiving intravitreal ranibizumab therapy followed by a ‘pump and dump’ strategy
Author Affiliations & Notes
  • Verena Juncal
    University of Toronto, Toronto, Ontario, Canada
  • Radha Kohly
    University of Toronto, Toronto, Ontario, Canada
  • Samara B Marafon
    University of Toronto, Toronto, Ontario, Canada
  • Natalia Albuquerque Lucena Figueiredo
    University of Toronto, Toronto, Ontario, Canada
  • Liran Hostovsky
    University of Toronto, Toronto, Ontario, Canada
  • Yenge Diambomba
    University of Toronto, Toronto, Ontario, Canada
  • Keyvan Koushan
    University of Toronto, Toronto, Ontario, Canada
  • Rajeev H Muni
    University of Toronto, Toronto, Ontario, Canada
  • Footnotes
    Commercial Relationships   Verena Juncal, None; Radha Kohly, None; Samara Marafon, None; Natalia Figueiredo, None; Liran Hostovsky, None; Yenge Diambomba, None; Keyvan Koushan, None; Rajeev Muni, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 446. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Verena Juncal, Radha Kohly, Samara B Marafon, Natalia Albuquerque Lucena Figueiredo, Liran Hostovsky, Yenge Diambomba, Keyvan Koushan, Rajeev H Muni; Levels of systemic VEGF-A and ranibizumab in the infant of a nursing mother receiving intravitreal ranibizumab therapy followed by a ‘pump and dump’ strategy. Invest. Ophthalmol. Vis. Sci. 2021;62(8):446.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : To analyze the levels of ranibizumab and vascular endothelial growth factor (VEGF)-A in the breast milk of a nursing mother and in the bloodstream of her infant after intravitreal ranibizumab injections followed by a 3-day ‘pump and dump’ strategy.

Methods : This is a prospective, interventional clinical study that included both a 34-year-old nursing patient who required bilateral ranibizumab injections post-partum and her newborn child. The mother received an injection of ranibizumab 0.5mg in each eye with 1-week interval between eyes. The infant was regularly breastfed, except for 3 days following each injection, when a ‘pump and dump’ strategy was adopted, where the mother regularly pumped and discarded the breast milk while the infant was fed exclusively with formula. Breast milk samples were obtained at baseline and then daily for 14 days after the first injection. The infant’s blood samples were obtained daily for 11 days starting on the day before breastfeeding was resumed. Plasma and serum samples were obtained for VEGF-A and ranibizumab analysis, respectively. In addition, blood samples of 3 control infants of similar gestational age as the index infant were obtained and analyzed for plasma VEGF-A levels

Results : Ranibizumab levels remained below the lower limit of quantitation (LLOQ) of the assay at all time points in the mother’s breast milk and in the infant’s serum. VEGF-A levels in the breast milk gradually reduced from 5266pg/ml at baseline to 1537pg/ml at day 11, and then increased to 3438pg/ml at day 14. Plasma VEGF-A levels in the infant remained below the LLOQ at all time points, except for days 9 (20.45pg/ml) and 11 (13.19pg/ml). Plasma VEGF-A levels in the control patients were also below the LLOQ.

Conclusions : Ranibizumab was not detected in the infant of a nursing mother who received intravitreal ranibizumab injection followed by a 3-day ‘pump and dump’ strategy and systemic VEGF-A levels did not seem to be affected. This suggests that a 3-day ‘pump and dump’ strategy could possibly be a safe option for nursing mothers who require intravitreal ranibizumab therapy but want to continue breastfeeding.

This is a 2021 ARVO Annual Meeting abstract.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×