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@ARTICLE{YuWaiMan:276827,
author = {Yu-Wai-Man, Patrick and Newman, Nancy J and Biousse,
Valérie and Carelli, Valerio and Moster, Mark L and
Vignal-Clermont, Catherine and Klopstock, Thomas and Sadun,
Alfredo A and Sergott, Robert C and Hage, Rabih and Degli
Esposti, Simona and La Morgia, Chiara and Priglinger,
Claudia and Karanja, Rustum and Taiel, Magali and Sahel,
José-Alain},
collaboration = {Group, LHON Study},
othercontributors = {Barboni, Piero and Carbonelli, Michele and Di Vito, Lidia
and Amore, Giulia and Contin, Manuela and Mohamed, Susan and
Silvestri, Sara and Baker Hubbard, George and Hendrick,
Andrew M and Dattilo, Michael and Peragallo, Jason H and
Hawy, Eman and DuBois, Lindreth and Gibbs, Deborah and
Fernandes Filho, Alcides and Dobbs, Jannah and Aung, Andre
and Acheson, James and Boston, Hayley and Eleftheriadou,
Maria and Gemenetzi, Maria and Leitch-Devlin, Lauren and
Tucker, William R and Jurkute, Neringa and Burale, Asma and
DeBusk, Adam A and Haller, Julia A and Massini, Maria and
SantaMaria, Melissa and Tollis, Heather and Girmens,
Jean-François and Plaine, Lise and Khemliche, Wahiba and
Catarino, Claudia B and Priglinger, Siegfried and Rudolph,
Günther and Thurau, Stephan and von Livonius, Bettina and
Muth, Daniel and Wolf, Armin and Al-Tamami, Jasmina and
Pressler, Angelika and Schertler, Cosima and Hildebrandt,
Martin and Neuenhahn, Michael and Heilweil, Gad and Tsui,
Irena},
title = {{F}ive-{Y}ear {O}utcomes of {L}enadogene {N}olparvovec
{G}ene {T}herapy in {L}eber {H}ereditary {O}ptic
{N}europathy.},
journal = {JAMA ophthalmology},
volume = {143},
number = {2},
issn = {2168-6165},
address = {Chicago, Ill.},
publisher = {American Medical Association},
reportid = {DZNE-2025-00340},
pages = {99},
year = {2025},
abstract = {Limited studies have assessed the long-term benefit/risk of
gene therapy for Leber hereditary optic neuropathy (LHON).To
determine the safety and efficacy of lenadogene nolparvovec
in patients with LHON due to the MT-ND4 gene variant for up
to 5 years after administration.The RESCUE and REVERSE
Long-Term Follow-up Study (RESTORE), conducted from 2018 to
2022, is the 5-year follow-up study of the 2 phase 3
clinical studies RESCUE (Efficacy Study of Lenadogene
Nolparvovec for the Treatment of Vision Loss Up to 6 Months
From Onset in LHON Due to the MT-ND4 Mutation) and REVERSE
(Efficacy Study of Lenadogene Nolparvovec for the Treatment
of Vision Loss From 7 Months to 1 Year From Onset in LHON
Due to the MT-ND4 Mutation). At the end of each study, ie, 2
years after gene therapy administration, patients were
offered enrollment in the RESTORE trial, a multinational,
multicenter, prospective study, for an additional 3 years of
follow-up. Patients with LHON due to the MT-ND4 gene variant
received lenadogene nolparvovec in 1 eye and a sham
injection in the other eye.Lenadogene nolparvovec was
administered as a single intravitreal injection in the
RESCUE/REVERSE studies.Measures included best-corrected
visual acuity (BCVA), quality of life using the National Eye
Institute visual functioning questionnaire 25 (NEI VFQ-25),
and adverse events.Among the 76 patients who received gene
therapy in the RESCUE (n = 39) and REVERSE (n = 37) studies,
72 $(94.7\%)$ completed these studies; 62 patients
$(81.6\%)$ participated in the RESTORE trial, and 55
patients $(72.4\%)$ completed the 5-year follow-up.
Participants were mostly male (49 $[79.0\%])$ with a mean
(SD) age of 35.9 (15.3) years at treatment. At baseline, the
mean (SD) BCVA was 1.5 (0.5) logMAR (20/600 Snellen) in eyes
to be treated with lenadogene nolparvovec and 1.4 (0.5)
logMAR (20/500) in sham eyes. At the end of the
RESCUE/REVERSE trials, ie, 2 years after treatment, eyes
treated with lenadogene nolparvovec and eyes treated with
sham reached a mean BCVA value of 1.4 (0.6) logMAR (20/500).
The mean (SD) change from baseline to year 2 was -0.05 (0.6)
logMAR (+1 line) and 0.01 (0.6) logMAR (-0 line) in gene
therapy-treated and sham eyes, respectively (difference,
-0.03; $95\%$ CI, -0.16 to 0.09; P = .60). Five years after
treatment, the bilateral improvement from nadir was similar
to that observed at 2 years, with a mean (SD) change in BCVA
of -0.4 (0.5) logMAR (more than +4 lines) for eyes treated
with lenadogene nolparvovec and -0.4 (0.4) logMAR (+4 lines)
for eyes treated with sham (difference, -0.05; $95\%$ CI,
-0.15 to 0.04; P = .27). An improvement of at least -0.3
logMAR (+3 lines) from the nadir in at least 1 eye was
observed in $66.1\%$ of participants (41 of 62). Between 2
and 5 years, intraocular inflammation was noted in 4
participants with 8 events in eyes treated with lenadogene
nolparvovec and 1 event in an eye treated with sham.In this
analysis of the RESTORE trial, follow-up of patients with
LHON due to the MT-ND4 gene variant unilaterally treated
with lenadogene nolparvovec demonstrated a sustained
bilateral improvement in BCVA and a good safety profile up
to 5 years after treatment. This evidence of persistent
benefit over time is promising for the use of gene therapy
in these patients.ClinicalTrials.gov Identifier:
NCT03406104.},
keywords = {Optic Atrophy, Hereditary, Leber: genetics / Optic Atrophy,
Hereditary, Leber: therapy / Optic Atrophy, Hereditary,
Leber: physiopathology / Humans / Genetic Therapy: methods /
Male / Visual Acuity: physiology / Female / Follow-Up
Studies / Adult / Prospective Studies / Treatment Outcome /
NADH Dehydrogenase: genetics / Genetic Vectors / Young Adult
/ Dependovirus: genetics / Adolescent / Mutation / Middle
Aged / DNA, Mitochondrial: genetics / Quality of Life / NADH
dehydrogenase subunit 4 (NLM Chemicals) / NADH Dehydrogenase
(NLM Chemicals) / DNA, Mitochondrial (NLM Chemicals)},
cin = {Clinical Research (Munich)},
ddc = {610},
cid = {I:(DE-2719)1111015},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39699886},
pmc = {pmc:PMC11843360},
doi = {10.1001/jamaophthalmol.2024.5375},
url = {https://pub.dzne.de/record/276827},
}