@article {106, title = {Safety and Proof-of-Concept Study of Oral QLT091001 in Retinitis Pigmentosa Due to Inherited Deficiencies of Retinal Pigment Epithelial 65 Protein (RPE65) or Lecithin:Retinol Acyltransferase (LRAT).}, journal = {PLoS One}, volume = {10}, year = {2015}, month = {2015}, pages = {e0143846}, abstract = {

UNLABELLED: Restoring vision in inherited retinal degenerations remains an unmet medical need. In mice exhibiting a genetically engineered block of the visual cycle, vision was recently successfully restored by oral administration of 9-cis-retinyl acetate (QLT091001). Safety and visual outcomes of a once-daily oral dose of 40 mg/m2/day QLT091001 for 7 consecutive days was investigated in an international, multi-center, open-label, proof-of-concept study in 18 patients with RPE65- or LRAT-related retinitis pigmentosa. Eight of 18 patients (44\%) showed a >=20\% increase and 4 of 18 (22\%) showed a >=40\% increase in functional retinal area determined from Goldmann visual fields; 12 (67\%) and 5 (28\%) of 18 patients showed a >=5 and >=10 ETDRS letter score increase of visual acuity, respectively, in one or both eyes at two or more visits within 2 months of treatment. In two patients who underwent fMRI, a significant positive response was measured to stimuli of medium contrast, moving, pattern targets in both left and right hemispheres of the occipital cortex. There were no serious adverse events. Treatment-related adverse events were transient and the most common included headache, photophobia, nausea, vomiting, and minor biochemical abnormalities. Measuring the outer segment length of the photoreceptor layer with high-definition optical coherence tomography was highly predictive of treatment responses with responders having a significantly larger baseline outer segment thickness (11.7 {\textpm} 4.8 μm, mean {\textpm} 95\% CI) than non-responders (3.5 {\textpm} 1.2 μm). This structure-function relationship suggests that treatment with QLT091001 is more likely to be efficacious if there is sufficient photoreceptor integrity.

TRIAL REGISTRATION: ClinicalTrials.gov NCT01014052.

}, keywords = {Acyltransferases, Administration, Oral, Adult, Anticarcinogenic Agents, Cerebral Cortex, Child, cis-trans-Isomerases, Drug Dosage Calculations, Female, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Radiography, Retinal Ganglion Cells, Retinal Neurons, Retinitis Pigmentosa, Treatment Outcome, Visual Acuity, Visual Fields, Vitamin A, Young Adult}, issn = {1932-6203}, doi = {10.1371/journal.pone.0143846}, author = {Scholl, Hendrik P N and Moore, Anthony T and Koenekoop, Robert K and Wen, Yuquan and Fishman, Gerald A and van den Born, L Ingeborgh and Bittner, Ava and Bowles, Kristen and Fletcher, Emily C and Collison, Frederick T and Dagnelie, Gislin and Degli Eposti, Simona and Michaelides, Michel and Saperstein, David A and Schuchard, Ronald A and Barnes, Claire and Zein, Wadih and Zobor, Ditta and Birch, David G and Mendola, Janine D and Zrenner, Eberhart} }