LAUSR

PURPOSE To identify geographic and socioeconomic variables predictive of residential proximity to neovascular age-related macular degeneration (nAMD) clinical trial locations. DESIGN Retrospective, cross-sectional study. METHODS Census-tract level data from public datasets and trial-level data from ClinicalTrials.gov were analyzed. MAIN OUTCOME MEASURES We calculated the driving distance (>60 miles) and time (>60 minutes) from the population-weighted United States (US) census tract centroid to the nearest clinical trial site. RESULTS We identified 42 trials studying nAMD across 829 unique clinical trial sites in the US. In a multivariable model, driving distance >60 miles had a significant association with rural location [adjusted odds ratio [aOR] 5.54; 95% confidence interval [CI] 3.86-7.96, p<0.0001] and Midwest (aOR 2.30; 95% CI 1.21-4.38, p=0.01) and South (aOR 2.43; 95% CI 1.21-4.91, p=0.01) as compared to the Northeast region, and some college or an Associates degree, as compared to a Bachelor's degree (aOR 1.02; 95% CI 1.01-1.04, p=0.0007) and (aOR 1.05; 95% CI 1.00-1.10, p=0.04), respectively. Lower odds of traveling > 60 miles to the nearest nAMD trial site were associated with census tracts with a higher percentage of blacks (aOR 0.98; 95% CI 0.97-0.99, p<0.0001), Hispanics (aOR 0.97; 95% CI 0.95-0.99, p=0.002) and Asians (aOR 0.90; 95% CI 0.88-0.93, p<0.0001), as compared to whites, and a lower percentage of the population <200% of the federal poverty level (FPL). Similar predictors were found in time traveled >60 minutes. CONCLUSIONS There are geographic access disparities of clinical trial sites for nAMD in the United States.