June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Predicting Non-response to Ranibizumab in Patients with Neovascular Age-related Macular Degeneration
Author Affiliations & Notes
  • Freekje van Asten
    Ophthalmology, UMC St Radboud, Nijmegen, Netherlands
  • Maroeska Rovers
    Epidemiology, Biostatistics and HTA, UMC St Radboud, Nijmegen, Netherlands
  • Yara Lechanteur
    Ophthalmology, UMC St Radboud, Nijmegen, Netherlands
  • Dzenita Smailhodzic
    Ophthalmology, UMC St Radboud, Nijmegen, Netherlands
  • Philipp Muether
    Ophthalmology, University of Cologne, Cologne, Germany
  • Anneke Den Hollander
    Ophthalmology, UMC St Radboud, Nijmegen, Netherlands
    Human Genetics, UMC St Radboud, Nijmegen, Netherlands
  • Sascha Fauser
    Ophthalmology, University of Cologne, Cologne, Germany
  • Carel Hoyng
    Ophthalmology, UMC St Radboud, Nijmegen, Netherlands
  • Gert Jan van der Wilt
    Epidemiology, Biostatistics and HTA, UMC St Radboud, Nijmegen, Netherlands
  • B. Jeroen Klevering
    Ophthalmology, UMC St Radboud, Nijmegen, Netherlands
  • Footnotes
    Commercial Relationships Freekje van Asten, None; Maroeska Rovers, None; Yara Lechanteur, None; Dzenita Smailhodzic, None; Philipp Muether, Heidelberg Engineering (C); Anneke Den Hollander, None; Sascha Fauser, None; Carel Hoyng, None; Gert Jan van der Wilt, None; B. Jeroen Klevering, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 246. doi:
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      Freekje van Asten, Maroeska Rovers, Yara Lechanteur, Dzenita Smailhodzic, Philipp Muether, Anneke Den Hollander, Sascha Fauser, Carel Hoyng, Gert Jan van der Wilt, B. Jeroen Klevering; Predicting Non-response to Ranibizumab in Patients with Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):246.

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

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Abstract

Purpose: To validate known and to determine new predictors of non-response to ranibizumab in patients with neovascular age-related macular degeneration (AMD) and to incorporate these factors into a prediction rule.

Methods: This multicenter, observational case series study included 394 patients treated with ranibizumab for neovascular AMD. We performed genetic analysis for single nucleotide polymorphisms in AMD-associated genes and collected questionnaires regarding environmental factors and disease history. The primary outcome was non-response to treatment, which we defined as a loss of visual acuity of 30% of letters or more on EDTRS chart.

Results: Of the 394 patients, 47 were classified as non-responder. Independent predictors for non-response were: age, baseline visual acuity, diabetes mellitus and accumulation of risk alleles in the CFH, ARMS2 and VEGF-A genes. The area under the receiver operating characteristic curve was 0.77 (95% confidence interval: 0.70 - 0.84). We derived a clinical prediction rule, with possible total risk scores ranging from 0 to 21 points. The absolute risk of non-response varied from 2% to 53% between risk score groups.

Conclusions: A straightforward clinical prediction rule can aid clinicians identifying AMD patients with an increased or decreased likelihood of non-response to treatment with ranibizumab.

Keywords: 412 age-related macular degeneration • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials  
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