Cited by 70Retinal Development and DisordersVirus-based gene therapy researchRetinal Diseases and Treatments

Gene therapy for inherited retinal disease: Long-term durability of effect

Open access
Leroy, Bart P., Fischer, M. Dominik, Flannery, John G., MacLaren, Robert E., Dalkara, Deniz, Scholl, Hendrik P.N., Chung, Daniel C., Spera, Claudio +2 more·2023·Ophthalmic Research

Abstract

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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Crossref · 10.1159/000526317

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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)
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
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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