LUMINOUS study shows diversity in practice patterns, overall encouraging results

COPENHAGEN — Registry data from the recently concluded LUMINOUS study, a real-life observational study on the long-term safety, effectiveness, treatment patterns and quality-of-life outcomes related to the use of Lucentis, were shown and discussed by Paolo Lanzetta, MD, at the Euretina meeting.

The study enrolled more than 30,000 patients in 40 countries from different continents and gathered information on retinal vascular diseases, including age-related macular degeneration, diabetic macular edema, retinal vein occlusion and myopic choroidal neovascularization.

Paolo Lanzetta

“AMD represented the vast majority, with 22,969 cases accounting for 75% of the whole study population. The U.K. was the top recruiter, with more than 10,000 patients,” Lanzetta said.

Due to the real-life nature of the study, there was great diversity concerning ethnicity, social conditions, age and baseline vision within the study population, as well as inclusion and exclusion criteria. Comorbidities were more frequent and more severe than in randomized controlled trials.

Differences in clinical practices included time intervals between diagnosis and treatment, with delays up to 1 month in Russia vs. same-day treatment in Japan and Poland. Lucentis (ranibizumab, Genentech/Novartis) injection frequency showed great variability, significantly impacting efficacy of treatment.

Lesion characteristics varied in relation to ethnicity. Polypoidal choroidal vasculopathy in Asian countries was, as expected, frequent, found in up to 30% of cases in Japan and Korea, while the rate was as low as 0.4% in Canada.

Best results were correlated with higher injection frequency. Most visual acuity gain was obtained before month 3 and was not maintained when treatment slowed down. Patients with lower visual acuity at baseline showed the largest improvement.

“On the whole, we cannot be dissatisfied, though we could do better and have the key on how to improve,” Lanzetta said.

Encouraging results were also seen in DME, RVO and myopic CNV, with reassuring safety data. – by Michela Cimberle

Reference:

Lanzetta P. A comprehensive look back on the real-world: The LUMINOUS registry. Presented at: 16th Euretina Congress; Sept. 8-11, 2016; Copenhagen, Denmark.

Disclosure: Lanzetta reports financial disclosures for Alcon, Alimera, Allergan, Bausch + Lomb, Bayer, Boehringer, CenterVue, Genentech, Iridex, Lupin, Lutronic, Novartis, Roche, Teva and Topcon.