Indirect Comparison of Lenadogene Nolparvovec Gene Therapy Versus Natural History in Patients with Leber Hereditary Optic Neuropathy Carrying the m.11778G>A MT-ND4 Mutation.

Gene therapy LHON Leber hereditary optic neuropathy MT-ND4 Natural history Visual acuity

Journal

Ophthalmology and therapy
ISSN: 2193-8245
Titre abrégé: Ophthalmol Ther
Pays: England
ID NLM: 101634502

Informations de publication

Date de publication:
Feb 2023
Historique:
received: 03 10 2022
accepted: 28 10 2022
pubmed: 1 12 2022
medline: 1 12 2022
entrez: 30 11 2022
Statut: ppublish

Résumé

Lenadogene nolparvovec is a promising novel gene therapy for patients with Leber hereditary optic neuropathy (LHON) carrying the m.11778G>A ND4 mutation (MT-ND4). A previous pooled analysis of phase 3 studies showed an improvement in visual acuity of patients injected with lenadogene nolparvovec compared to natural history. Here, we report updated results by incorporating data from the latest phase 3 trial REFLECT in the pool, increasing the number of treated patients from 76 to 174. The visual acuity of 174 MT-ND4-carrying patients with LHON injected in one or both eyes with lenadogene nolparvovec from four pooled phase 3 studies (REVERSE, RESCUE and their long-term extension trial RESTORE; and REFLECT trial) was compared to the spontaneous evolution of an external control group of 208 matched patients from 11 natural history studies. Treated patients showed a clinically relevant and sustained improvement in their visual acuity when compared to natural history. Mean improvement versus natural history was - 0.30 logMAR (+ 15 ETDRS letters equivalent) at last observation (P < 0.01) with a maximal follow-up of 3.9 years after injection. Most treated eyes were on-chart as compared to less than half of natural history eyes at 48 months after vision loss (89.6% versus 48.1%; P < 0.01) and at last observation (76.1% versus 44.4%; P < 0.01). When we adjusted for covariates of interest (gender, age of onset, ethnicity, and duration of follow-up), the estimated mean gain was - 0.43 logMAR (+ 21.5 ETDRS letters equivalent) versus natural history at last observation (P < 0.0001). Treatment effect was consistent across all phase 3 clinical trials. Analyses from REFLECT suggest a larger treatment effect in patients receiving bilateral injection compared to unilateral injection. The efficacy of lenadogene nolparvovec in improving visual acuity in MT-ND4 LHON was confirmed in a large cohort of patients, compared to the spontaneous natural history decline. Bilateral injection of gene therapy may offer added benefits over unilateral injection. NCT02652780 (REVERSE); NCT02652767 (RESCUE); NCT03406104 (RESTORE); NCT03293524 (REFLECT); NCT03295071 (REALITY).

Identifiants

pubmed: 36449262
doi: 10.1007/s40123-022-00611-x
pii: 10.1007/s40123-022-00611-x
pmc: PMC9834474
doi:

Banques de données

ClinicalTrials.gov
['NCT02652780', 'NCT02652767', 'NCT03406104', 'NCT03293524', 'NCT03295071']

Types de publication

Journal Article

Langues

eng

Pagination

401-429

Subventions

Organisme : Medical Research Council
ID : G0701386
Pays : United Kingdom
Organisme : Medical Research Council
ID : G1002570
Pays : United Kingdom
Organisme : NEI NIH HHS
ID : P30 EY006360
Pays : United States

Investigateurs

Valerio Carelli (V)
Piero Barboni (P)
Michele Carbonelli (M)
Lidia Di Vito (L)
Giulia Amore (G)
Manuela Contin (M)
Susan Mohamed (S)
Chiara La Morgia (C)
Sara Silvestri (S)
Pietro D'Agati (P)
Nancy J Newman (NJ)
Valérie Biousse (V)
George Baker Hubbard (GB)
Ghazala O'Keefe (G)
Andrew M Hendrick (AM)
Michael Dattilo (M)
Jason H Peragallo (JH)
Eman Hawy (E)
Lindreth DuBois (L)
Deborah Gibbs (D)
Alcides Fernandes Filho (AF)
Jannah Dobbs (J)
Patrick Yu-Wai-Man (P)
James Acheson (J)
Hayley Boston (H)
Maria Eleftheriadou (M)
Simona Esposti (S)
Maria Gemenetzi (M)
Lauren Leitch-Devlin (L)
William R Tucker (WR)
Neringa Jurkute (N)
Asma Burale (A)
Shweta Anand (S)
Muhammad A Memon (MA)
Rima Hussain (R)
Rasha Jorany (R)
Priyansha Sheel (P)
Mark L Moster (ML)
Robert C Sergott (RC)
Melissa SantaMaria (M)
Heather Tollis (H)
Adam A DeBusk (AA)
Julia A Haller (JA)
Maria Massini (M)
Prem S Subramanian (PS)
Paula Pecen (P)
Marc Mathias (M)
Mary Preston (M)
Steve Cho (S)
José A Sahel (JA)
Catherine Vignal-Clermont (C)
Jean François Girmens (JF)
Rabih Hage (R)
Lise Plaine (L)
Wahiba Khemliche (W)
An-Guor Wang (AG)
Hui-Chen Cheng (HC)
Celia Chen (C)
Jeong-Min Hwang (JM)
Chuanbin Sun (C)
Sean Donahue (S)
Shriji Patel (S)
Sapna Gangaputra (S)
Megan Barrett (M)
Scott Ruark (S)
Saige Wilkins (S)
Bart P Leroy (BP)
Julie De Zaeytijd (J)
Caroline Van Cauwenbergh (C)
Hilde Verhauwen (H)
Thomas Klopstock (T)
Claudia B Catarino (CB)
Claudia Priglinger (C)
Siegfried Priglinger (S)
Günther Rudolph (G)
Stephan Thurau von Livonius Bettina (ST)
Daniel Muth (D)
Armin Wolf (A)
Jasmina Al-Tamami (J)
Angelika Pressler (A)
Cosima Schertler (C)
Martin Hildebrandt (M)
Michael Neuenhahn (M)
Alfredo A Sadun (AA)
Gad Heilweil (G)
Rustum Karanjia (R)
Irena Tsui (I)
Gema Rebolleda Fernández (G)
Laia Jaumendreu Urquijo (LJ)
Francisco J Negrete Muñoz (FJ)
Elizabeth Fortin (E)
Bart K Chwalisz (BK)
Dean Cestari (D)
Rudrani Banik (R)
Katy Tai (K)
Lorena Castillo (L)
Virginia Garcia (V)
Antonio Morilla Francesco Bandello (AMF)
Piero Barboni (P)
Maria Lucia Cascavilla (ML)
Marco Battista (M)
Francesca Calcagno (F)
Adelaide Pina (A)
Stéphanie Leruez (S)
Rod Forooza (R)

Informations de copyright

© 2022. The Author(s).

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Auteurs

Valerio Carelli (V)

Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Via Altura, 3, 40139, Bologna, BO, Italy. valerio.carelli@unibo.it.
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy. valerio.carelli@unibo.it.

Nancy J Newman (NJ)

Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Department of Neurological Surgery, Emory University School of Medicine, Atlanta, GA, USA.

Patrick Yu-Wai-Man (P)

Department of Clinical Neurosciences, Cambridge Centre for Brain Repair and MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK.
Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Moorfields Eye Hospital, NHS Foundation Trust, London, UK.
Institute of Ophthalmology, University College London, London, UK.

Valerie Biousse (V)

Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Department of Neurological Surgery, Emory University School of Medicine, Atlanta, GA, USA.

Mark L Moster (ML)

Department of Neurology, Wills Eye Hospital and Thomas Jefferson University, Philadelphia, PA, USA.
Department of Ophthalmology, Wills Eye Hospital and Thomas Jefferson University, Philadelphia, PA, USA.

Prem S Subramanian (PS)

Sue Anschutz-Rodgers University of Colorado Eye Center, University of Colorado School of Medicine, Aurora, CO, USA.

Catherine Vignal-Clermont (C)

Department of Neuro Ophthalmology and Emergencies, Rothschild Foundation Hospital, Paris, France.
Centre d'Investigation Clinique, Centre Hospitalier National d'Ophtalmologie des Quinze Vingts, Paris, France.

An-Guor Wang (AG)

Department of Ophthalmology, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Sean P Donahue (SP)

Department of Ophthalmology, Neurology, and Pediatrics, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA.

Bart P Leroy (BP)

Department of Ophthalmology and Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium.
Department of Head & Skin, Ghent University, Ghent, Belgium.

Robert C Sergott (RC)

Department of Neurology, Wills Eye Hospital and Thomas Jefferson University, Philadelphia, PA, USA.
Department of Ophthalmology, Wills Eye Hospital and Thomas Jefferson University, Philadelphia, PA, USA.

Thomas Klopstock (T)

Department of Neurology, Friedrich-Baur-Institute, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.

Alfredo A Sadun (AA)

David Geffen, Doheny Eye Institute, School of Medicine, University of California, Los Angeles, CA, USA.

Gema Rebolleda Fernández (G)

Department of Ophthalmology, Alcala University, Madrid, Spain.

Bart K Chwalisz (BK)

Department of Ophthalmology, Massachusetts Eye & Ear, Harvard Medical School, Boston, MA, USA.

Rudrani Banik (R)

Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Jean François Girmens (JF)

Centre d'Investigation Clinique, Centre Hospitalier National d'Ophtalmologie des Quinze Vingts, Paris, France.

Chiara La Morgia (C)

Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Via Altura, 3, 40139, Bologna, BO, Italy.
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.

Adam A DeBusk (AA)

Department of Neurology, Wills Eye Hospital and Thomas Jefferson University, Philadelphia, PA, USA.
Department of Ophthalmology, Wills Eye Hospital and Thomas Jefferson University, Philadelphia, PA, USA.

Neringa Jurkute (N)

Moorfields Eye Hospital, NHS Foundation Trust, London, UK.
Institute of Ophthalmology, University College London, London, UK.
Department of Neuro-Ophthalmology, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.

Claudia Priglinger (C)

Department of Ophthalmology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.

Rustum Karanjia (R)

David Geffen, Doheny Eye Institute, School of Medicine, University of California, Los Angeles, CA, USA.
Department of Ophthalmology, University of Ottawa Eye, Ottawa, ON, Canada.

Constant Josse (C)

eXYSTAT, Data Management and Statistic, Malakoff, France.

Julie Salzmann (J)

Medical and Regulatory Consulting, Paris, France.

François Montestruc (F)

eXYSTAT, Data Management and Statistic, Malakoff, France.

Michel Roux (M)

GenSight Biologics, Paris, France.

Magali Taiel (M)

GenSight Biologics, Paris, France.

José-Alain Sahel (JA)

Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France.
Rothschild Foundation Hospital, Paris, France.
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Institut Hospitalo-Universitaire FOReSIGHT, INSERM-DGOS CIC 1423, Paris, France.

Classifications MeSH