van Asten, Freekje ORCID: 0000-0002-8141-4234, Rovers, Maroeska M., Lechanteur, Yara T. E., Smailhodzic, Dzenita, Muether, Philipp S., Chen, John, den Hollander, Anneke I., Fauser, Sascha, Hoyng, Carel B., van der Wilt, Gert Jan ORCID: 0000-0002-5856-762X and Klevering, B. Jeroen (2014). Predicting Non-response to Ranibizumab in Patients with Neovascular Age-related Macular Degeneration. Ophthalmic Epidemiol., 21 (6). S. 347 - 356. PHILADELPHIA: TAYLOR & FRANCIS INC. ISSN 1744-5086

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Abstract

Purpose: To validate known and 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 cohort study included 391 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, defined as a loss of visual acuity >= 30% of letters. Results: Of the 391 patients, 47 were classified as non-responsive. 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 0-19 points. The absolute risk of non-response varied from 3-52% between risk score groups. Conclusion: This is an important step towards a clinical prediction rule that can aid clinicians in identifying AMD patients with increased likelihood of non-response, and consequently contribute to making shared treatment decisions.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
van Asten, FreekjeUNSPECIFIEDorcid.org/0000-0002-8141-4234UNSPECIFIED
Rovers, Maroeska M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lechanteur, Yara T. E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smailhodzic, DzenitaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muether, Philipp S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chen, JohnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
den Hollander, Anneke I.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fauser, SaschaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoyng, Carel B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Wilt, Gert JanUNSPECIFIEDorcid.org/0000-0002-5856-762XUNSPECIFIED
Klevering, B. JeroenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-422784
DOI: 10.3109/09286586.2014.949010
Journal or Publication Title: Ophthalmic Epidemiol.
Volume: 21
Number: 6
Page Range: S. 347 - 356
Date: 2014
Publisher: TAYLOR & FRANCIS INC
Place of Publication: PHILADELPHIA
ISSN: 1744-5086
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
COMPLEMENT FACTOR-H; INTRAVITREAL RANIBIZUMAB; SUBGROUP ANALYSIS; POOLED FINDINGS; RISK-FACTORS; BEVACIZUMAB; ASSOCIATION; THERAPY; VERTEPORFIN; MACULOPATHYMultiple languages
OphthalmologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/42278

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