Statistical analysis plan for the Laser-1st versus Drops-1st for Glaucoma and Ocular Hypertension Trial (LiGHT): a multi-centre randomised controlled trial

Victoria Vickerstaff, Gareth Ambler, Catey Bunce, Wen Xing, Gus Gazzard, LiGHT Trial Study Group, Gus Gazzard, Sarah Wilson, David Broadway, Sheng Lim, Rupert Bourne, Timothy Manners, Nicholas Strouthidis, Keith Barton, Richard Wormald, Stephen Morris, Rachael Hunter, Gary Rubin, David Garway-Heath, Marta Buszewicz, Gareth Ambler, Catey Bunce, Victoria Vickerstaff, Amanda Davis, Neil Nathwani, Evgenia Konstantakopoulou, Haogang Zhou, Yuzhen Jiang, Victoria Vickerstaff, Gareth Ambler, Catey Bunce, Wen Xing, Gus Gazzard, LiGHT Trial Study Group, Gus Gazzard, Sarah Wilson, David Broadway, Sheng Lim, Rupert Bourne, Timothy Manners, Nicholas Strouthidis, Keith Barton, Richard Wormald, Stephen Morris, Rachael Hunter, Gary Rubin, David Garway-Heath, Marta Buszewicz, Gareth Ambler, Catey Bunce, Victoria Vickerstaff, Amanda Davis, Neil Nathwani, Evgenia Konstantakopoulou, Haogang Zhou, Yuzhen Jiang

Abstract

Background: The LiGHT trial (Laser-1st versus Drops-1st for Glaucoma and Ocular Hypertension Trial) is a multicentre randomised controlled trial of two treatment pathways for patients who are newly diagnosed with open-angle glaucoma (OAG) and ocular hypertension (OHT). The main hypothesis for the trial is that lowering intraocular pressure (IOP) with selective laser trabeculoplasty (SLT) as the primary treatment ('Laser-1st') leads to a better health-related quality of life than for those started on IOP-lowering drops as their primary treatment ('Medicine-1st') and that this is associated with reduced costs and improved tolerability of treatment. This paper describes the statistical analysis plan for the study.

Methods/design: The LiGHT trial is an unmasked, multi-centre randomised controlled trial. A total of 718 patients (359 per arm) are being randomised to two groups: medicine-first or laser-first treatment. Outcomes are recorded at baseline and at 6-month intervals up to 36 months. The primary outcome measure is health-related quality of life (HRQL) at 36 months measured using the EQ-5D-5L. The main secondary outcome is the Glaucoma Utility Index. We plan to analyse the patient outcome data according to the group to which the patient was originally assigned. Methods of statistical analysis are described, including the handling of missing data, the covariates used in the adjusted analyses and the planned sensitivity analyses.

Trial registration: The trial was registered with the ISRCTN register on 23/07/2012, number ISRCTN32038223 .

References

    1. Minassian D, Reidy A, Coffey M, Minassian A. Utility of predictive equations for estimating the prevalence and incidence of primary open angle glaucoma in the UK. Br J Ophthalmol. 2000;84:1159–61. doi: 10.1136/bjo.84.10.1159.
    1. Parrish RK, Gedde SJ, Scott IU, Feuer WJ, Schiffman JC, Mangione CM, et al. Visual function and quality of life among patients with glaucoma. Arch Ophthalmol. 1997;115:1447–55. doi: 10.1001/archopht.1997.01100160617016.
    1. Nelson P, Aspinall P, Papasouliotis O, Worton B, O’Brien C. Quality of life in glaucoma and its relationship with visual function. J Glaucoma. 2003;12:139–50. doi: 10.1097/00061198-200304000-00009.
    1. Gutierrez P, Wilson MR, Johnson C, Gordon M, Cioffi GA, Ritch R, et al. Influence of glaucomatous visual field loss on health-related quality of life. Arch Ophthalmol. 1997;115:777–84. doi: 10.1001/archopht.1997.01100150779014.
    1. Nelson P, Aspinall P, O’Brien C. Patients’ perception of visual impairment in glaucoma: a pilot study. Br J Ophthalmol. 1999;83:546–52. doi: 10.1136/bjo.83.5.546.
    1. Higginbotham EJ, Gordon MO, Beiser JA, Drake MV, Bennett GR, Wilson MR, et al. The Ocular Hypertension Treatment Study: Topical Medication Delays or Prevents Primary Open-angle Glaucomain African American Individuals. Arch Ophthalmol. 2004;122:813–20. doi: 10.1001/archopht.122.6.813.
    1. Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120:701–13. doi: 10.1001/archopht.120.6.701.
    1. LOCSU. National Eye Health Epidemiological Model (NEHEM) . Accessed 12 October 2015.
    1. Zhao J, Jia L, Sui R, Ellwein LB. Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Am J Ophthalmol. 1998;126:487–624. doi: 10.1016/S0002-9394(98)00223-2.
    1. Drance S. The Collaborative Normal-Tension Glaucoma Study and some of its lessons. Can J Ophthalmol. 1999;34:1.
    1. Lichter PR, Musch DC, Gillespie BW, Guire KE, Janz NK, Wren PA, et al. Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery. Ophthalmology. 2001;108:1943–53. doi: 10.1016/S0161-6420(01)00873-9.
    1. Investigators A. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol. 2000;130:429–40. doi: 10.1016/S0002-9394(00)00538-9.
    1. Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol. 2003;121:48–56. doi: 10.1001/archopht.121.1.48.
    1. Barton K. Bleb dysesthesia. J Glaucoma. 2003;12:281–4. doi: 10.1097/00061198-200306000-00018.
    1. Budenz DL, Hoffman K, Zacchei A. Glaucoma filtering bleb dysesthesia. Am J Ophthalmol. 2001;131:626–30. doi: 10.1016/S0002-9394(00)00901-6.
    1. Balkrishnan R, Brent Bond J, Byerly WG, Camacho FT, Anderson RT. Medication-related predictors of health-related quality of life in glaucoma patients enrolled in a medicare health maintenance organization. Am J Geriatr Pharmac. 2003;1:75–81. doi: 10.1016/S1543-5946(03)90003-1.
    1. Group ICoHEEW ICH Harmonised Tripartite Guideline. Statistical principles for clinical trials. Stat Med. 1999;18:1905–42.
    1. Aspinall PA, Johnson ZK, Azuara-Blanco A, Montarzino A, Brice R, Vickers A. Evaluation of quality of life and priorities of patients with glaucoma. Invest Ophthalmol Vis Sci. 2008;49:1907–15. doi: 10.1167/iovs.07-0559.
    1. Brown H, Prescott R. Applied mixed models in medicine: Statistics in practice. 2nd Ed. Chichester: John Wiley & Sons; 2006.

Source: PubMed

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