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Patient characteristics and treatment of neovascular age-related macular degeneration in France: the LUEUR1 observational study

  • Retinal Disorders
  • Published:
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Abstract

Background

Age-related macular degeneration is the primary cause of blindness in developed countries. Current treatments of this degenerative disease mainly include laser, photodynamic therapy with verteporfin and administration of anti-vascular endothelial growth factors. The LUEUR (LUcentis® En Utilisation Réelle) study is composed of a cross-sectional part (LUEUR1), which examined the current management of wet AMD in France, and a follow-up part (LUEUR2), which will assess the development of patients treated for wet AMD over 4 years. Here we describe the results of LUEUR1.

Methods

Patients with wet AMD were enrolled during a routine medical examination in LUEUR1, a cross-sectional, observational, prospective, multicentre study. Investigators recorded patient demographics, visual acuity, characteristics of wet AMD lesions, date of AMD diagnosis, comorbidities, previous treatments, treatments prescribed at inclusion, and low vision rehabilitation.

Results

A total of 72 investigators recruited 1,019 patients with wet AMD, corresponding to 1,405 eyes affected by the disease. The mean age of patients was 78.7 ± 7.3 years. Most were female (62.3%) and non-smokers (66.9%). The mean visual acuity was 49.12 ± 24.18 Early Treatment Diabetic Retinopathy Study letters. Most eyes showed occult (52.8%) and subfoveal (84.6%) choroidal neovascularisation. Bilateral wet AMD affected 37.9% of patients. The median time since diagnosis was 12 months. Ranibizumab-based therapy (67.3%) and photodynamic therapy (29.8%) were the most frequent previous treatments. Prior to inclusion, 5.6% of patients had low vision rehabilitation. When a treatment was prescribed on the day of inclusion, it was most often ranibizumab (89.0% of all treatments at inclusion).

Conclusions

The results of this study illustrate the impact of anti-vascular endothelial growth factor therapies on the treatment of wet AMD in a real-life context. Specifically, ranibizumab-based therapy appears to have largely replaced laser photocoagulation and verteporfin-based photodynamic therapy.

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Abbreviations

AMD:

age-related macular degeneration

CNV:

choroidal neovascularisation

PDT:

photodynamic therapy

VEGF:

vascular endothelial growth factor

ETDRS:

Early Treatment Diabetic Retinopathy Study

References

  1. Resnikoff S, Pascolini D, Etya'ale D, Kocur I, Pararajasegaram R, Pokharel GP, Mariotti SP (2004) Global data on visual impairment in the year 2002. Bull World Health Organ 82:844–851

    PubMed  Google Scholar 

  2. Friedman DS, O'Colmain BJ, Muñoz B, Tomany SC, McCarty C, de Jong PTVM, Nemesure B, Mitchell P, Kempen J (2004) Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol 122:564–572

    Article  PubMed  Google Scholar 

  3. Schmidt-Erfurth UM, Richard G, Augustin A, Aylward WG, Bandello F, Corcòstegui B, Cunha-Vaz J, Gaudric A, Leys A, Schlingemann RO (2007) Guidance for the treatment of neovascular age-related macular degeneration. Acta Ophthalmol Scand 85:486–494

    Article  PubMed  CAS  Google Scholar 

  4. de Jong PTVM (2006) Age-related macular degeneration. N Engl J Med 355:1474–1485

    Article  PubMed  Google Scholar 

  5. Evans JR (2001) Risk factors for age-related macular degeneration. Prog Retin Eye Res 20:227–253

    Article  PubMed  CAS  Google Scholar 

  6. Baird PN, Hageman GS, Guymer RH (2009) New era for personalized medicine: the diagnosis and management of age-related macular degeneration. Clin Experiment Ophthalmol 37:814–821

    Article  PubMed  Google Scholar 

  7. Leveziel N, Zerbib J, Richard F, Querques G, Morineau G, Fremeaux-Bacchi V, Coscas G, Soubrane G, Benlian P, Souied EH (2008) Genotype-phenotype correlations for exudative age-related macular degeneration associated with homozygous HTRA1 and CFH genotypes. Invest Ophthalmol Vis Sci 49:3090–3094

    Article  PubMed  Google Scholar 

  8. Ferrara N, Gerber H-P, LeCouter J (2003) The biology of VEGF and its receptors. Nat Med 9:669–676

    Article  PubMed  CAS  Google Scholar 

  9. Hubschman JP, Reddy S, Schwartz SD (2009) Age-related macular degeneration: current treatments. Clin Ophthalmol 3:155–166

    Article  PubMed  CAS  Google Scholar 

  10. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY (2006) Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 355:1419–1431

    Article  PubMed  CAS  Google Scholar 

  11. Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S (2006) Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 355:1432–1444

    Article  PubMed  CAS  Google Scholar 

  12. Beutel J, Rudolf M, Grisanti S (2009) Current and future therapies for age-related macular degeneration. Expert Opin Emerg Drugs 14:341–362

    Article  PubMed  CAS  Google Scholar 

  13. Zanlonghi X, Avital L, Pedelahore C, Robin C, Baty F (2003) Comment explorer la vision dans un contexte de conduite automobile? Conduite et age. Octopus Multimédia, Paris, pp 101–105

    Google Scholar 

  14. Delcourt C, Michel F, Colvez A, Lacroux A, Delage M, Vernet MH, POLA Study Group (2001) Associations of cardiovascular disease and its risk factors with age-related macular degeneration: the POLA study. Ophthalmic Epidemiol 8:237–249

    Article  PubMed  CAS  Google Scholar 

  15. Zawinka C, Ergun E, Stur M (2005) Prevalence of patients presenting with neovascular age-related macular degeneration in an urban population. Retina 25:324–331

    Article  PubMed  Google Scholar 

  16. Wong TY, Wong T, Chakravarthy U, Klein R, Mitchell P, Zlateva G, Buggage R, Fahrbach K, Probst C, Sledge I (2008) The natural history and prognosis of neovascular age-related macular degeneration: a systematic review of the literature and meta-analysis. Ophthalmology 115:116–126

    Article  PubMed  Google Scholar 

  17. Bonastre J, Le Pen C, Soubrane G, Quentel G (2003) The burden of age-related macular degeneration: results of a cohort study in two French referral centres. Pharmacoeconomics 21:181–190

    Article  PubMed  Google Scholar 

  18. Ergun E, Zawinka C, Stur M (2004) Incidence of laser photocoagulation and photodynamic therapy with verteporfin at a tertiary retinal center. Retina 24:13–18

    Article  PubMed  Google Scholar 

  19. Cohen SY, Creuzot-Garcher C, Darmon J, Desmettre T, Korobelnik JF, Levrat F, Quentel G, Paliès S, Sanchez A, de Gendre AS, Schluep H, Weber M, Delcourt C (2007) Types of choroidal neovascularisation in newly diagnosed exudative age-related macular degeneration. Br J Ophthalmol 91:1173–1176

    Article  PubMed  CAS  Google Scholar 

  20. Macular Photocoagulation Study Group (1997) Risk factors for choroidal neovascularization in the second eye of patients with juxtafoveal or subfoveal choroidal neovascularization secondary to age-related macular degeneration. Arch Ophthalmol 115:741–747

    Google Scholar 

  21. Solomon SD, Jefferys JL, Hawkins BS, Bressler NM (2007) Incident choroidal neovascularization in fellow eyes of patients with unilateral subfoveal choroidal neovascularization secondary to age-related macular degeneration. SST report No. 20 from the Submacular Surgery Trials Research Group. Arch Ophthalmol 125:1323–1330

    Article  PubMed  Google Scholar 

  22. Chang TS, Bressler NM, Fine JT, Dolan CM, Ward J, Klesert TR (2007) Improved vision-related function after Ranibizumab treatment of neovascular age-related macular degeneration: results of a randomized clinical trial. Arch Ophthalmol 125:1460–1469

    Article  PubMed  CAS  Google Scholar 

  23. Bressler NM, Chang TS, Fine JT, Dolan CM, Ward J (2009) Improved vision-related function after ranibizumab vs photodynamic therapy: a randomized clinical trial. Arch Ophthalmol 127:13–21

    Article  PubMed  CAS  Google Scholar 

  24. van Velthoven MEJ, de Smet MD, Schlingemann RO, Magnani M, Verbraak FD (2006) Added value of OCT in evaluating the presence of leakage in patients with age-related macular degeneration treated with PDT. Graefes Arch Clin Exp Ophthalmol 244:1119–1123

    Article  PubMed  Google Scholar 

  25. Fung AE, Lalwani GA, Rosenfeld PJ, Dubovy SR, Michels S, Feuer WJ, Puliafito CA, Davis JL, Flynn HW, Esquiabro M (2007) An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol 143:566–583

    Article  PubMed  CAS  Google Scholar 

  26. ANAES report. [Traitements de la dégénérescence maculaire liée à l'âge]. http://www.has-sante.fr/portail/upload/docs/application/pdf/DMLA.rap.pdf (accessed 08 Feb 2010)

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Acknowledgments

We thank the physicians who kindly participated in this study. The study was conducted by EZUS, University of Lyon, France for Novartis Pharma and by the study scientific committee (SY Cohen, G De Pouvourville, G Dupeyron, M Lievre, E Souied and M Weber). All members of the scientific committee had a direct role in study design, analysis and interpretation of data as well as in the writing of and decision to submit this manuscript. We also thank 4Clinics (Waterloo, Belgium) for assistance in writing this manuscript.

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Authors and Affiliations

  1. Centre Ophtalmologique d’Imagerie et de Laser, 11 rue Antoine Bourdelle, 75015, Paris, France

    Salomon-Yves Cohen

  2. Faculté de Medecine Henri Mondor, Creteil University Eye Clinic, 40 Avenue de Verdun, 94000, Créteil, France

    Eric H. Souied

  3. Ophthalmology Department, Hôtel-Dieu University Hospital, 1 place Alexis-Ricordeau, 44093, Nantes Cedex 1, France

    Michel Weber

  4. Ophthalmology Department, Nimes University Hospital, Place du Pr R. Debré, 30029, Nîmes cedex 9, France

    Gérard Dupeyron

  5. Health Economics, ESSEC, Avenue Bernard Hirsch, B.P. 50105, 95021, Cergy-Pontoise, France

    Gérard de Pouvourville

  6. Clinical Pharmacology Department, Lyon 1 University, Service de Pharmacologie Clinique, Faculté de Médecine, rue Guillaume Paradin, 69008, Lyon, France

    Michel Lievre

  7. Novartis Pharma SAS, 2 et 4, rue Lionel Terray, B.P. 308, 92506, Rueil Malmaison, France

    Anne Ponthieux

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  1. Salomon-Yves Cohen
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  2. Eric H. Souied
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  3. Michel Weber
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  4. Gérard Dupeyron
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  5. Gérard de Pouvourville
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  6. Michel Lievre
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  7. Anne Ponthieux
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Corresponding author

Correspondence to Anne Ponthieux.

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Funding and competing interests

This study was sponsored by Novartis Pharma SAS, France. SY Cohen, G De Pouvourville, G Dupeyron, M Lievre, E Souied and M Weber are consultants for Novartis Pharma, France. A Ponthieux is an employee of Novartis Pharma, France. The authors have full control of all primary data, and they agree to allow Graefe's Archive for Clinical and Experimental Ophthalmology to review their data upon request.

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Cohen, SY., Souied, E.H., Weber, M. et al. Patient characteristics and treatment of neovascular age-related macular degeneration in France: the LUEUR1 observational study. Graefes Arch Clin Exp Ophthalmol 249, 521–527 (2011). https://doi.org/10.1007/s00417-010-1553-0

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  • DOI: https://doi.org/10.1007/s00417-010-1553-0

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