Side Effects of Eylea, Zaltrap Injections May Increase Risk of Eye Inflammation: Study

Swelling from Eylea and Zaltrap can take weeks to resolve, leaving patients with scaring and the potential need for additional treatments, researchers indicate.

Researchers warn in a new study that individuals who receive injections of Eylea or Zaltrap may experience complications and side effects, which are treatable, but could impair their vision.

The findings were published in the journal JAMA Ophthalmology on May 1, indicating that side effects of Eylea and Zaltrap injections may increase the risk of eye inflammation, with swelling being a more common than clinical trials previously indicated.

Zaltrap and Eylea both use aflibercept as the active ingredient, and are anti-vascular endothelial growth factor (VEGF) eye injections administered for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME).

VEGF is a protein that helps new blood vessels grow. The injections prevent the growth of new blood vessels, which can help stabilize patient vision and prevent more damage to the eye.

Dr. Peter Charbel Issa and researchers from Technical University of Munich analyzed 2024 data from 41 patients treated at a medical clinic, who had previously received other VEGF inhibitors before being treated with an 8 mg injection of Eylea or Zaltrap.

Roughly half of the patients had age-related macular degeneration, and the other half had diabetic macular edema. Overall, 136 injections were administered to patient eyes during the observation period.

The findings indicate five patients developed mild sterile intraocular inflammation within one to three days after receiving an injection. The data indicated the incidence of inflammation per injection was 4%, but 12% per patient overall.

Researchers noted that four patients had prior exposure to Eylea or Zaltrap injections before the study. All patients were treated with anti-inflammatory therapy. Two patients also needed oral corticosteroids, but all cases resolved after treatment.

Inflammation after anti-VEGF injections can stem from infections inside the eye or from autoimmune causes. However, it’s important for patients to be seen by a doctor so any complications can be resolved quickly, researchers warned.

The researchers suspect that intraocular inflammation after Eylea injections may be more common than previously reported, noting that clinical trial participants were often not examined for several weeks, whereas patients treated in real-world eye clinics are typically seen for follow-up within four days.

While the intraocular inflammation was considered mild, researchers said patient education is necessary to ensure risk factors are considered to prevent side effects. The reduction in vision associated with inflammation can be frightening to patients and can take weeks to resolve.

Researchers also said early follow-up appointments are necessary to help detect mild side effects that were routinely missed during clinical trials.