Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 20;12(8):3013.
doi: 10.3390/jcm12083013.

A Multi-Modal AI-Driven Cohort Selection Tool to Predict Suboptimal Non-Responders to Aflibercept Loading-Phase for Neovascular Age-Related Macular Degeneration: PRECISE Study Report 1

Michal Chorev  1 , Jonas Haderlein  1 , Shruti Chandra  2 , Geeta Menon  3 , Benjamin J L Burton  4 , Ian Pearce  5 , Martin McKibbin  6 , Sridevi Thottarath  2 , Eleni Karatsai  2 , Swati Chandak  2 , Ajay Kotagiri  7 , James Talks  8 , Anna Grabowska  9 , Faruque Ghanchi  10 , Richard Gale  11 , Robin Hamilton  2 , Bhavna Antony  1 , Rahil Garnavi  1 , Iven Mareels  1 , Andrea Giani  12 , Victor Chong  13 , Sobha Sivaprasad  2   13
Affiliations

A Multi-Modal AI-Driven Cohort Selection Tool to Predict Suboptimal Non-Responders to Aflibercept Loading-Phase for Neovascular Age-Related Macular Degeneration: PRECISE Study Report 1

Michal Chorev et al. J Clin Med. .

Abstract

Patients diagnosed with exudative neovascular age-related macular degeneration are commonly treated with anti-vascular endothelial growth factor (anti-VEGF) agents. However, response to treatment is heterogeneous, without a clinical explanation. Predicting suboptimal response at baseline will enable more efficient clinical trial designs for novel, future interventions and facilitate individualised therapies. In this multicentre study, we trained a multi-modal artificial intelligence (AI) system to identify suboptimal responders to the loading-phase of the anti-VEGF agent aflibercept from baseline characteristics. We collected clinical features and optical coherence tomography scans from 1720 eyes of 1612 patients between 2019 and 2021. We evaluated our AI system as a patient selection method by emulating hypothetical clinical trials of different sizes based on our test set. Our method detected up to 57.6% more suboptimal responders than random selection, and up to 24.2% more than any alternative selection criteria tested. Applying this method to the entry process of candidates into randomised controlled trials may contribute to the success of such trials and further inform personalised care.

Keywords: aflibercept; age-related macular degeneration; loading-phase; multimodal artificial intelligence; predictive modelling.

PubMed Disclaimer

Conflict of interest statement

Michal Chorev, Jonas Haderlein, Rahil Garnavi, Bhavna Antony, and Iven Mareels were all IBM employees while working on this study. Andrea Giani is an employee of Boehringer Ingelheim. Sobha Sivaprasad received consultancy fees from Bayer, Allergan, Novartis Pharma AG, Roche, Boehringer Ingelheim, Optos, Apellis, Oxurion, Oculis, and Heidelberg Engineering. Victor Chong is an employee of Janssen R&D and previously of Boehringer Ingelheim. Benjamin Burton is on the advisory board for and has received international conference attendance sponsored by Novartis and Bayer. Geeta Menon has conducted consultancy-advisory boards for Novartis, Bayer, and Allergan, and received educational travel grants from Novartis, Bayer, and Allergan. Ian Pearce has received lecture fees from Allergan, Bayer, Heidelberg, and Novartis, consultancy fees from Allergan, Alimera, Bayer, and Novartis, and travel fees from Allergan, Bayer, and Novartis. Faruque Ghanchi has received honoraria for consultancy-advisory boards from Alimera, Allergan, Bayer, Novartis, Oxford BioElectronics, and Roche, and educational travel grants from Allergan, Bayer, and Novartis. Martin McKibbin has received lecture and advisory board honoraria from Bayer and Novartis and an educational travel grant from Bayer. Robin Hamilton has received non-financial assistance and personal fees and been an advisor to Novartis, Bayer, Allergan, Roche, and Ellex. Richard Gale has conducted consultancy-advisory boards for Novartis, Bayer, Allergan, Alimera, and Santen, and has received educational travel grants from Novartis, Bayer, Allergan, and Heidelberg Engineering. James Talks is a consultant for Bayer and Novartis, has received grant support from Bayer, Novartis, and Heidelberg Engineering, and is involved in research for Allergan, Roche, Bayer, Novartis, and Boehringer Ingelheim. Ajay Kotagiri has received travel support from Novartis, Bayer, and Allergan, and speaker fees from Allergan and Bayer.

Figures

Figure 1
Figure 1
Participant flow.
Figure 2
Figure 2
Temporal differences between eyes undergoing standard versus short protocol. Density shown on the x-axis refers to total count of eyes normalised to one.
See this image and copyright information in PMC

References

    1. Friedman D.S., O’Colmain B.J., Muñoz B., Tomany S.C., McCarty C., De Jong P.T.V.M., Nemesure B., Mitchell P., Kempen J., Congdon N. Prevalence of Age-Related Macular Degeneration in the United States. Arch. Ophthalmol. 2004;122:564–572. doi: 10.1001/archopht.122.4.564. - DOI - PubMed
    1. Wong W.L., Su X., Li X., Cheung C.M.G., Klein R., Cheng C.Y., Wong T.Y. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: A systematic review and meta-analysis. Lancet Glob. Health. 2014;2:e106–e116. doi: 10.1016/S2214-109X(13)70145-1. - DOI - PubMed
    1. Ishikawa M., Jin D., Sawada Y., Abe S., Yoshitomi T. Future Therapies of Wet Age-Related Macular Degeneration. J. Ophthalmol. 2015;2015:138070. doi: 10.1155/2015/138070. - DOI - PMC - PubMed
    1. Finger R.P., Wickremasinghe S.S., Baird P.N., Guymer R.H. Predictors of anti-VEGF treatment response in neovascular age-related macular degeneration. Surv. Ophthalmol. 2014;59:1–18. doi: 10.1016/j.survophthal.2013.03.009. - DOI - PubMed
    1. Kaiser P.K. Emerging therapies for neovascular age-related macular degeneration: Drugs in the pipeline. Ophthalmology. 2013;120:S11–S15. doi: 10.1016/j.ophtha.2013.01.061. - DOI - PubMed

LinkOut - more resources