Gene therapy for inherited retinal disease: Long-term durability of effect
Open accessAbstract
The recent approval of voretigene neparvovec (Luxturna®) for patients with biallelic RPE65 mutation-associated inherited retinal dystrophy with viable retinal cells represents an important step in the development of ocular gene therapies. Herein, we review studies investigating the episomal persistence of different recombinant adeno-associated virus (rAAV) vector genomes and the preclinical and clinical evidence of long-term effects of different RPE65 gene replacement therapies. A targeted review of articles published between 1974 and January 2021 in Medline®, Embase®, and other databases was conducted, followed by a descriptive longitudinal analysis of the clinical trial outcomes of voretigene neparvovec. Following an initial screening, 14 publications examining the episomal persistence of different rAAV genomes and 71 publications evaluating gene therapies in animal models were included. Viral genomes were found to persist for at least 22 months (longest study follow-up) as transcriptionally active episomes. Treatment effects lasting almost a decade were reported in canine disease models, with more pronounced effects the earlier the intervention. The clinical trial outcomes of voretigene neparvovec are consistent with preclinical findings and reveal sustained results for up to 7.5 years for the full-field light sensitivity threshold test and 5 years for the multi-luminance mobility test in the Phase I and Phase III trials, respectively. In conclusion, the therapeutic effect of voretigene neparvovec lasts for at least a decade in animal models and 7.5 years in human subjects. Since retinal cells can retain functionality over their lifetime after transduction, these effects may be expected to last even longer in patients with a sufficient number of outer retinal cells at the time of intervention.
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AAV vectors have shown promise as a gene therapy technology due to their effectiveness and ability to sustain gene expression for several years in certain IRDs.
“adeno-associated virus (AAV) vectors have shown promise as a gene therapy technology due to their effectiveness and ability to sustain gene expression for several years in certain IRDs [239,240,241].”
From Bruch’s Membrane: A Key Consideration with Complement-Based Therapies for Age-Related Macular Degeneration (2023) · cites this paper as [241]
Follow-up studies show that Luxturna's therapeutic effect lasts at least 7.5 years.
“Follow-up studies show that Luxturna's therapeutic effect lasts at least 7.5 years. 36”
From Innovative therapies for inherited retinal dystrophies: navigating DNA, RNA, and protein approaches (2025) · cites this paper as [36]
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Retinitis Pigmentosa: Current Clinical Management and Emerging Therapies
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AAV-NDI1 Therapy Provides Significant Benefit to Murine and Cellular Models of Glaucoma
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- Authors
- Leroy, B. P., Fischer, M. D., Flannery, J. G., MacLaren, R. E., Dalkara, D., Scholl, H. P. N., Chung, D. C., Spera, C., Viriato, D., & Banhazi, J.
- Affiliations
- Children's Hospital of Philadelphia (US)
- University of Oxford (GB)
- University of California, Berkeley (US)
- Centre National de la Recherche Scientifique (FR)
- University of Basel (CH)
- Novartis (Switzerland) (CH)
- ORCID
- Venue
- Ophthalmic Research
- Publisher
- S. Karger AG
- Published
- 2022-09-14
- Volume
- 66
- Issue
- 1
- Pages
- 179-196
- ISSN
- 0030-3747 (ISSN-L)
- 1423-0259
- OpenAlex
- W4295720447
- Cited by
- 70
- References
- 120
- Citations by year
- 2026: 5 · 2025: 32 · 2024: 18 · 2023: 14 · 2022: 1
- FWCI
- 1.69
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Ophthalmic Research (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- National Institute for Health and Care Research (NIHR201338)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Virus-based gene therapy research
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Keywords
- gene therapy, inherited retinal disease, RPE65 mutations, voretigene neparvovec, Luxturna, recombinant adeno-associated virus vectors, retinal dystrophy, visual acuity
- MeSH terms
- Animals, Dogs, Genetic Vectors, Humans, Retina, Vision, Ocular, Genetic Therapy, cis-trans-Isomerases, Retinal Dystrophies
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