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Dhooge PP, Möller PT, Boon CJ, Lotery AJ, Herrmann P, Battaglia Parodi M, Klein W, Fsadni MG, Wheeler-Schilling TH, Jungmann O, Müller H, Holz FG, Schmitz-Valckenberg S, Peters TM, Stingl K, Hoyng CB. The STArgardt Remofuscin Treatment Trial (STARTT): design and baseline characteristics of enrolled Stargardt patients. Open Res Eur 2022; 1:96. [PMID: 37645124 PMCID: PMC10445898 DOI: 10.12688/openreseurope.13872.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 08/31/2023]
Abstract
Background: This report describes the study design and baseline characteristics of patients with Stargardt disease (STGD1) enrolled in the STArgardt Remofuscin Treatment Trial (STARTT). Methods: In total, 87 patients with genetically confirmed STGD1 were randomized in a double-masked, placebo-controlled proof of concept trial to evaluate the safety and efficacy of 20 milligram oral remofuscin for 24 months. The primary outcome measure is change in mean quantitative autofluorescence value of an 8-segment ring centred on the fovea (qAF 8). Secondary efficacy variables are best corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), mesopic microperimetry (mMP), spectral domain optical coherence tomography (SD-OCT), reading speed on Radner reading charts, and patient-reported visual function as assessed by the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25) and Functional Reading Independence (FRI) Index. Results: Mean age of participants was 35±11 years with 49 (56%) female. Median qAF 8 value was 438 Units (range 210-729). Median BCVA and LLVA in decimal units were 0.50 (range 0.13-0.80) and 0.20 (range 0.06-0.63), respectively. The median of the mean retinal sensitivity with mMP was 20.4 dB (range 0.0-28.8). SD-OCT showed median central subfield retinal thickness of 142 µm (range 72-265) and median macular volume of 1.65 mm 3 (range 1.13-2.19). Compared to persons without vision impairment, both reading performance and patient-reported visual function were significantly lower (p<0.001, one sample t-test). Mean reading speed was 108±39 words/minute with logRAD-score of 0.45±0.28. Mean VFQ-25 composite score was 72±13. Mean FRI Index score 2.8±0.6. Conclusions: This trial design may serve as reference for future clinical trials as it explores the utility of qAF 8 as primary outcome measure. The baseline data represent the largest, multi-national, STGD1 cohort to date that underwent standardized qAF imaging, reading speed assessment and vision-related quality of life measures which all contribute to the characterization of STGD1. EudraCT registration: 2018-001496-20 (09/05/2019).
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Affiliation(s)
- Patty P.A. Dhooge
- Department of Ophthalmology, Radboud University Nijmegen Medical Centre, Nijmegen, 6500HB, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, 6525EN, The Netherlands
| | - Philipp T. Möller
- GRADE reading center, Bonn, 53127, Germany
- Department of Ophthalmology, University of Bonn, Bonn, 53127, Germany
| | - Camiel J.F. Boon
- Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, 1081HV, The Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, 2333ZA, The Netherlands
| | - Andrew J. Lotery
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
| | - Philipp Herrmann
- Department of Ophthalmology, University of Bonn, Bonn, 53127, Germany
- Center for Rare Diseases Bonn (ZSEB), University of Bonn, Bonn, 53113, Germany
| | | | | | - Mario G. Fsadni
- Katairo GmbH, Kusterdingen, 72127, Germany
- International Pharm-Med Ltd, Hemel Hempstead, HP1 1LD, UK
| | - Thomas H. Wheeler-Schilling
- University Eye Hospital, Center for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, 72076, Germany
| | - Oliver Jungmann
- Smerud Medical Research Germany GmbH, Mannheim, D-68161, Germany
| | - Hans Müller
- Smerud Medical Research Germany GmbH, Mannheim, D-68161, Germany
| | - Frank G. Holz
- GRADE reading center, Bonn, 53127, Germany
- Department of Ophthalmology, University of Bonn, Bonn, 53127, Germany
| | - Steffen Schmitz-Valckenberg
- GRADE reading center, Bonn, 53127, Germany
- Department of Ophthalmology, University of Bonn, Bonn, 53127, Germany
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, 84132, USA
| | - Tobias M. Peters
- University Eye Hospital, Center for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, 72076, Germany
| | - Katarina Stingl
- University Eye Hospital, Center for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, 72076, Germany
- Center for Rare Eye Diseases, University of Tübingen, Tübingen, 72076, Germany
| | - Carel B. Hoyng
- Department of Ophthalmology, Radboud University Nijmegen Medical Centre, Nijmegen, 6500HB, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, 6525EN, The Netherlands
| | - Soraprazan Consortium
- Department of Ophthalmology, Radboud University Nijmegen Medical Centre, Nijmegen, 6500HB, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, 6525EN, The Netherlands
- GRADE reading center, Bonn, 53127, Germany
- Department of Ophthalmology, University of Bonn, Bonn, 53127, Germany
- Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, 1081HV, The Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, 2333ZA, The Netherlands
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
- Center for Rare Diseases Bonn (ZSEB), University of Bonn, Bonn, 53113, Germany
- Department of Ophthalmology, Ospedale San Raffaele, Milan, 20132, Italy
- Katairo GmbH, Kusterdingen, 72127, Germany
- International Pharm-Med Ltd, Hemel Hempstead, HP1 1LD, UK
- University Eye Hospital, Center for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, 72076, Germany
- Smerud Medical Research Germany GmbH, Mannheim, D-68161, Germany
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, 84132, USA
- Center for Rare Eye Diseases, University of Tübingen, Tübingen, 72076, Germany
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