Docosahexaenoic Acid Slows Visual Field Progression in X-Linked Retinitis Pigmentosa: Ancillary Outcomes of the DHAX Trial

Hoffman, Dennis R.; Hughbanks-Wheaton, Dianna K.; Spencer, Rand; Fish, Gary E.; Pearson, Nancy; Wang, Yizhong; Klein, Martin; Takacs, Alison; Locke, Kirsten G.; Birch, David G.

doi:10.1167/iovs.15-17786

Cited by 47 publications

(42 citation statements)

References 31 publications

(44 reference statements)

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“…9 This study failed to show positive results for visual acuity but informed a trend to a reduced annual rate in the progression of loss of visual field sensitivity. However, in our opinion, this isolated mild positive result for DHA, especially when found in an ancillary analysis, 10 does not constitute a solid evidence of effectiveness for this supplement. Regarding safety evidence, the authors commented on the need for a cautious approach when applying fatty acid supplementation to patients with a family history of gastrointestinal intolerance (as in Crohn's disease).…”

Section: Discussioncontrasting

confidence: 56%

“…Finally, 8 studies informed in 13 articles were included in the present review. [9][10][11][12][13][14][15][16][17][18][19][20][21] Characteristics of studies…”

Section: Resultsmentioning

confidence: 99%

“…12 Except Lee et al which studied Best disease, 18 all included studies are on RP. [9][10][11][12][13][14][15][16][17][19][20][21] They assessed supplements based on vitamin A and vitamin E, 12 docosahexaenoic acid (DHA), 9,10,14,16,18 and the carotenoids lutein, 11,13 and β-carotene. 19 We did not identify eligible studies about other HRDs.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, both trials of Hoffman et al did not find any significant mean difference in visual acuity between DHA and placebo groups during a 4 years follow-up period. 9,10,16 Regarding studies on lutein supplementation, Berson et al did not find additional effect of this carotenoid in the annual decline of ETDRS letters in a population supplemented with vitamin A. 13 Bahrami et al found a statistically significant improvement (P = 0.018) of visual acuity related to lutein when measured in very low illumination conditions (0.1%), but not in normal (100%) or low (4%) illumination conditions.…”

Section: Retinitis Pigmentosamentioning

confidence: 98%

See 3 more Smart Citations

Effectiveness and safety of nutritional supplements in the treatment of hereditary retinal dystrophies: a systematic review

Brito-García

Pino-Sedeño

Trujillo-Martín

et al. 2016

Eye

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Section: Discussioncontrasting

confidence: 56%

“…Finally, 8 studies informed in 13 articles were included in the present review. [9][10][11][12][13][14][15][16][17][18][19][20][21] Characteristics of studies…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Retinitis Pigmentosamentioning

confidence: 98%

See 2 more Smart Citations

Effectiveness and safety of nutritional supplements in the treatment of hereditary retinal dystrophies: a systematic review

Brito-García

Pino-Sedeño

Trujillo-Martín

et al. 2016

Eye

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“…Eine vierjährige placebokontrollierte Studie mit 51 Patienten mit X-chromosomaler Retinitis pigmentosa ergab, dass eine hochdosierte DHA-Supplementierung ein sehr gutes Sicherheitsprofil zeigte und die Sensitivität des Gesichtsfelds signifikant erhalten konnte [28]. Der Erhalt des Gesichtsfelds war dabei direkt mit der Normalisierung des DHASpiegels im Blut korreliert.…”

Section: Docosahexaensäure (Dha)unclassified

Mikroglia und Immuntherapien bei degenerativen Netzhauterkrankungen

Karlstetter

Dannhausen

Langmann

2017

Medizinische Genetik

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Zusammenfassung Bei allen bisher im Detail untersuchten erblichen Netzhautdegenerationen liegt eine dem Erkrankungsverlauf abträgliche chronische Aktivierung des angeborenen Immunsystems zugrunde. Vor allem residente Mikrogliazellen der Netzhaut und verschiedene Proteine des löslichen Komplementsystems tragen zu einer Schädigung von Photorezeptoren und retinalem Pigmentepithel bei. Sowohl spezifische Zielstrukturen auf reaktiven Immunzellen als auch fehlregulierte lösliche Immunmodulatoren bieten neue Ansatzpunkte für Therapien, um das Überleben der Netzhaut trotz genetischer Prädisposition zur Degeneration zu fördern. Dieser Beitrag gibt Einblick in die wesentlichen Regulationsmechanismen der Netzhautimmunologie, diskutiert die mögliche Verwendung immunologischer Biomarker für die Netzhautdiagnostik und zeigt immunmodulierende Therapieansätze durch Biologika und endogene Botenstoffe auf.

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Effect of Oral Valproic Acid vs Placebo for Vision Loss in Patients With Autosomal Dominant Retinitis Pigmentosa

et al. 2018

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IMPORTANCE There are no approved drug treatments for autosomal dominant retinitis pigmentosa, a relentlessly progressive cause of adult and childhood blindness. OBJECTIVES To evaluate the potential efficacy and assess the safety of orally administered valproic acid (VPA) in the treatment of autosomal dominant retinitis pigmentosa. DESIGN, SETTING, AND PARTICIPANTS Multicenter, phase 2, prospective, interventional, placebo-controlled, double-masked randomized clinical trial. The study took place in 6 US academic retinal degeneration centers. Individuals with genetically characterized autosomal dominant retinitis pigmentosa were randomly assigned to receive treatment or placebo for 12 months. Analyses were intention-to-treat. INTERVENTIONS Oral VPA 500 mg to 1000 mg daily for 12 months or placebo. MAIN OUTCOMES AND MEASURES The primary outcome measure was determined prior to study initiation as the change in visual field area (assessed by the III4e isopter, semiautomated kinetic perimetry) between baseline and month 12. RESULTS The mean (SD) age of the 90 participants was 50.4 (11.6) years. Forty-four (48.9%) were women, 87 (96.7%) were white, and 79 (87.8%) were non-Hispanic. Seventy-nine participants (87.8%) completed the study (42 [95.5%] received placebo and 37 [80.4%] received VPA). Forty-two (46.7%) had a rhodopsin mutation. Most adverse events were mild, although 7 serious adverse events unrelated to VPA were reported. The difference between the VPA and placebo arms for mean change in the primary outcome was −150.43 degree 2 (95% CI, −290.5 to −10.03; P = .035). CONCLUSIONS AND RELEVANCE This negative value indicates that the VPA arm had worse outcomes than the placebo group. This study brings to light the key methodological considerations that should be applied to the rigorous evaluation of treatments for these conditions. This study does not provide support for the use of VPA in the treatment of autosomal dominant retinitis pigmentosa.

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Docosahexaenoic Acid Slows Visual Field Progression in X-Linked Retinitis Pigmentosa: Ancillary Outcomes of the DHAX Trial

Cited by 47 publications

References 31 publications

Effectiveness and safety of nutritional supplements in the treatment of hereditary retinal dystrophies: a systematic review

Effectiveness and safety of nutritional supplements in the treatment of hereditary retinal dystrophies: a systematic review

Mikroglia und Immuntherapien bei degenerativen Netzhauterkrankungen

Effect of Oral Valproic Acid vs Placebo for Vision Loss in Patients With Autosomal Dominant Retinitis Pigmentosa

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