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Rhee T, Kim J, Ha A. Preservative-Free Fixed Combination of Tafluprost 0.0015% and Timolol 0.5% for Treatment-Naive Patients with Open-Angle Glaucoma. KOREAN JOURNAL OF OPHTHALMOLOGY 2024; 38:221-226. [PMID: 38665112 PMCID: PMC11175986 DOI: 10.3341/kjo.2024.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/13/2024] [Accepted: 04/18/2024] [Indexed: 06/15/2024] Open
Abstract
PURPOSE To assess efficacy, safety, and tolerability of the preservative-free (PF) fixed-dose combination (FC) of tafluprost 0.0015%/timolol 0.5% (PF tafluprost/timolol FC) in treatments-naive patients with primary open-angle glaucoma (POAG). METHODS This was a retrospective, real-world clinical practice setting study that included 107 eyes of 107 subjects with POAG who had never been treated for glaucoma. All subjects were received PF tafluprost/timolol FC once daily. Intraocular pressure (IOP) levels were documented for each eye at the untreated baseline and up to 6 months after the initiation of medical treatment. All adverse events, including ocular and systemic adverse reactions, were recorded. Additionally, the reasons for medication discontinuations were thoroughly documented. RESULTS A total of 32 POAG patients with high-baseline IOP (>21 mmHg) and 75 with normal-baseline IOP were included in the study. The subjects' baseline mean age was 62.4 ± 8.7 years (range, 26.0-85.0 years); among them, 42 were female (39.3%). Mean IOP at baseline for all patients was 18.6 ± 4.3 mmHg. The mean IOP at 6 months was 12.6 ± 4.7 mmHg, representing a significant decrease compared to the baseline (-32%, p < 0.001). In POAG patients with high-baseline IOP, mean IOP was significantly lowered from 28.0 ± 5.7 mmHg at baseline to 18.0 ± 5.5 mmHg (-35%, p < 0.001); in patients with normal-baseline IOP, from 14.6 ± 3.4 mmHg at baseline to 10.3 ± 4.1 mmHg (-29%, p < 0.001). PF tafluprost/timolol FC was well-tolerated and safe. After 6 months, 97.2% of all patients remained on therapy. CONCLUSIONS In this real-world observational study, once-daily treatment with PF tafluprost/timolol FC demonstrated clinically relevant and statistically significant efficacy, as well as safety and good tolerability, in treatment-naive patients diagnosed with POAG.
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Affiliation(s)
| | - Jaeheon Kim
- Department of Ophthalmology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju,
Korea
| | - Ahnul Ha
- Department of Ophthalmology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju,
Korea
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Paoli CJ, Linder J, Gurjar K, Thakur D, Wyckmans J, Grieve S. Effectiveness of Single-Tablet Combination Therapy in Improving Adherence and Persistence and the Relation to Clinical and Economic Outcomes. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2024; 11:8-22. [PMID: 38500521 PMCID: PMC10948140 DOI: 10.36469/001c.91396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 03/20/2024]
Abstract
Background: Single-tablet combination therapies (STCTs) combine multiple drugs into one formulation, making drug administration more convenient for patients. STCTs were developed to address concerns with treatment adherence and persistence, but the impact of STCT use is not fully understood across indications. Objectives: We conducted a systematic literature review (SLR) to examine STCT-associated outcomes across 4 evidence domains: clinical trials, real-world evidence (RWE), health-related quality of life (HRQoL) studies, and economic evaluations. Methods: Four SLRs were conducted across the aforementioned domains. Included studies compared STCTs as well as fixed-dose combinations ([FDCs] of non-tablet formulations) with the equivalent active compounds and doses in loose-dose combinations (LDCs). Original research articles were included; case reports, case series, and non-English-language sources were excluded. Databases searched included EconLit, Embase, and Ovid MEDLINE® ALL. Two independent reviewers assessed relevant studies and extracted data. Conflicts were resolved with a third reviewer or consensus-based discussion. Results: In all, 109 studies were identified; 27 studies were identified in more than one SLR. Treatment adherence was significantly higher in patients receiving FDCs vs LDCs in 12 of 13 RWE studies and 3 of 13 clinical trials. All 18 RWE studies reported higher persistence with FDCs. In RWE studies examining clinical outcomes (n = 17), 14 reported positive findings with FDCs, including a reduced need for add-on medication, blood pressure control, and improved hemoglobin A1C. HRQoL studies generally reported numerical improvements with STCTs or similarities between STCTs and LDCs. Economic outcomes favored STCT use. All 6 cost-effectiveness or cost-utility analyses found FDCs were less expensive and more efficacious than LDCs. Four budget impact models found that STCTs were associated with cost savings. Medical costs and healthcare resource use were generally lower with FDCs than with LDCs. Discussion: Evidence from RWE and economic studies strongly favored STCT use, while clinical trials and HRQoL studies primarily reported similarity between STCTs and LDCs. This may be due to clinical trial procedures aimed at maximizing adherence and HRQoL measures that are not designed to evaluate drug administration. Conclusions: Our findings highlight the value of STCTs for improving patient adherence, persistence, and clinical outcomes while also offering economic advantages.
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Affiliation(s)
- Carly J Paoli
- Janssen Pharmaceutical Companies of Johnson & Johnson, Titusville, New Jersey, USA
| | - Jörg Linder
- Janssen-Cliag of Johnson & Johnson, Neuss, Germany
| | | | | | - Julie Wyckmans
- Janssen Pharmaceutical Companies of Johnson & Johnson, Basel, Switzerland
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Oddone F. Reviewing the evidence surrounding preservative-free tafluprost/timolol fixed-dose combination therapy in open angle glaucoma and ocular hypertension management: a focus on efficacy, safety and tolerability. Expert Opin Drug Saf 2022; 21:1259-1268. [PMID: 36250245 DOI: 10.1080/14740338.2022.2135701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Elevated intraocular pressure (IOP) is the most important modifiable risk factor for irreversible sight loss in open angle glaucoma (OAG). The topical fixed-dose combination (FC) of preservative-free (PF) tafluprost (0.0015%) and timolol (0.5%) (tafluprost/timolol) is among the second-line IOP-lowering options for OAG and ocular hypertension (OHT). AREAS COVERED PubMed searches identified publications reporting key evidence from randomized controlled trials (RCTs) and real-world studies examining the safety, tolerability and IOP-lowering efficacy of PF tafluprost/timolol FC therapy in OAG/OHT management. EXPERT OPINION Glaucoma patients are more likely to have ocular surface disease and treatment should be individualized so that target response may be achieved while considering tolerability and quality of life, according to European Glaucoma Society guidelines. PF FC therapies, such as PF tafluprost/timolol FC, avoid ocular surface exposure to toxic preservative agents and reduce the required number of treatment administrations. These properties may enhance treatment tolerability and adherence, resulting in improved IOP-lowering efficacy and disease control. Treatment outcomes from RCTs and real-world studies examining PF tafluprost/timolol FC therapy support this hypothesis, with significant IOP reductions and/or improvements in tolerability parameters demonstrated, regardless of the prior topical therapy used and even when switched directly to PF tafluprost/timolol FC treatment (without washout).
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Zhou X, Zhang X, Zhou D, Zhao Y, Duan X. A Narrative Review of Ocular Surface Disease Related to Anti-Glaucomatous Medications. Ophthalmol Ther 2022; 11:1681-1704. [PMID: 35943668 PMCID: PMC9437175 DOI: 10.1007/s40123-022-00557-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/29/2022] [Indexed: 01/31/2023] Open
Abstract
Topical anti-glaucomatous medications are still the most important measure to lower intraocular pressure. Large number of studies have confirmed that long-term use of anti-glaucomatous eye drops, especially containing benzalkonium chloride, a preservative, can cause or aggravate ocular surface injury. Ocular surface diseases damage the ocular microenvironmental health status, reduce the patients’ compliance with the treatment, and finally affect the treatment result. Therefore, the ocular surface management of patients with glaucoma is very important. This includes the selection of drugs that are better tolerated according to individual conditions, preservative-free formulations, drugs that protect against ocular surface disease, or selecting surgery and laser treatment, to prevent the damage to the ocular surface by topical anti-glaucomatous drugs.
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Affiliation(s)
- Xiaoyu Zhou
- Changsha Aier Eye Hospital, Changsha, Hunan Province, China.,The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xinyue Zhang
- Changsha Aier Eye Hospital, Changsha, Hunan Province, China.,The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Dengming Zhou
- The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yang Zhao
- Changsha Aier Eye Hospital, Changsha, Hunan Province, China.,The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xuanchu Duan
- Changsha Aier Eye Hospital, Changsha, Hunan Province, China. .,Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China.
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Oddone F, Scorcia V, Iester M, Sisto D, De Cilla S, Bettin P, Cagini C, Figus M, Marchini G, Rossetti L, Rossi G, Salgarello T, Scuderi GL, Staurenghi G. Treatment of Open-Angle Glaucoma and Ocular Hypertension with the Fixed-Dose Combination of Preservative-Free Tafluprost/Timolol: Clinical Outcomes from Ophthalmology Clinics in Italy. Clin Ophthalmol 2022; 16:1707-1719. [PMID: 35677639 PMCID: PMC9167838 DOI: 10.2147/opth.s364880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/11/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction The VISIONARY study examined the intraocular pressure (IOP)-lowering efficacy and tolerability of the preservative-free fixed-dose combination of tafluprost (0.0015%) and timolol (0.5%) (PF tafluprost/timolol FC) in a real-world setting. The country-level data reported herein comprise the largest and first observational study of PF tafluprost/timolol FC therapy in Italy. Methods An observational, multicenter, prospective study included adult Italian patients with open-angle glaucoma (OAG) or ocular hypertension (OHT) demonstrating insufficient response or poor tolerability with topical prostaglandin analogue (PGA) or beta-blocker monotherapy. Treatment was switched to PF tafluprost/timolol FC therapy at baseline. Primary endpoint was the absolute mean IOP change from baseline at Month 6. Exploratory and safety endpoints included change in IOP at Weeks 4 and 12, ocular signs, symptom severity and reporting of adverse events (AEs). Results Overall, 160 OAG/OHT patients were included. Mean ± standard deviation IOP was reduced from 19.6 ± 3.6 mmHg at baseline to 14.5 ± 2.6 mmHg at Month 6 (reduction of 5.1 ± 3.7 mmHg; 24.1%; p < 0.0001). IOP reduction was also statistically significant at Week 4 (23.1%; p < 0.0001) and Week 12 (24.7%; p < 0.0001). Based on data cutoff values for mean IOP change of ≥20%, ≥25%, ≥30% and ≥35%, respective Month 6 responder rates were 68.1%, 48.7%, 36.2% and 26.9%. Most ocular signs and symptoms were significantly reduced in severity from baseline at Month 6. Two non-serious and mild AEs were reported during the study period, among which, one AE was treatment-related (eyelash growth). Conclusion Italian OAG and OHT patients demonstrated a significant IOP reduction from baseline at Week 4 that was maintained over a 6-month period following a switch from topical PGA or beta-blocker monotherapy to PF tafluprost/timolol FC therapy. Severity of most ocular signs and symptoms was significantly reduced during the study period, and PF tafluprost/timolol FC was generally well tolerated.
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Affiliation(s)
- Francesco Oddone
- Glaucoma Unit, IRCSS-Fondazione Bietti, Roma, Italy
- Correspondence: Francesco Oddone, Glaucoma Unit, IRCSS-Fondazione Bietti, Roma, Italy, Tel + 39 06 85356727, Email
| | - Vincenzo Scorcia
- Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Michele Iester
- Eye Clinic of Genoa, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Genova, Italy
| | - Dario Sisto
- Ophthalmology Department, University of Bari, Bari, Italy
| | - Stefano De Cilla
- Department of Health Sciences, Eye Clinic, University of Piemonte Orientale, Novara, Italy
| | - Paolo Bettin
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milano, Italy
| | - Carlo Cagini
- Department of Medicine and Surgery, Ophthalmology Section, University of Perugia, Perugia, Italy
| | - Michele Figus
- Ophthalmology, Department of Surgery, Medicine, Molecular and Emergency, University of Pisa, Pisa, Italy
| | - Giorgio Marchini
- Ophthalmology Unit, Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Luca Rossetti
- Eye Clinic, San Paolo Hospital, University of Milan, Milano, Italy
| | - Gemma Rossi
- University Eye Clinic, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Tommaso Salgarello
- Ophthalmology Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Institute of Ophthalmology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Gian Luca Scuderi
- NESMOS Department, Ophthalmology Unit, St. Andrea Hospital, Università di Roma La Sapienza, Roma, Italy
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milano, Italy
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Ansari E, Chappiti S, Pavicic-Astalos J, Pinto-Bonilla JC, Riva I, Sacchi M, Saénz-Francés F. Treatment of open-angle glaucoma and ocular hypertension with preservative-free tafluprost/timolol fixed-dose combination therapy: 6 case reports and clinical outcomes. BMC Ophthalmol 2022; 22:152. [PMID: 35366846 PMCID: PMC8977001 DOI: 10.1186/s12886-022-02361-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/20/2022] [Indexed: 01/11/2023] Open
Abstract
Abstract
Background
Treatment of open angle glaucoma (OAG) and/or ocular hypertension (OHT) focuses on achievement of target intraocular pressure (IOP), with the objective of slowing disease progression. However, ocular surface health is an important consideration in the optimization of treatment. We report 6 patient cases in which enhanced IOP control was achieved following appropriate management of ocular surface inflammation and a therapeutic switch to the preservative-free (PF) tafluprost (0.0015%)/timolol (0.5%) fixed-dose combination (FC).
Case presentation
Six patient cases, aged 48–74 years, presented with OAG or OHT. Each patient had signs and symptoms of ocular surface disease (OSD). Cases 1–3 were each receiving maximal medical therapy for OAG; regimens comprising prostaglandin analogue (PGA), β-blocker, carbonic anhydrase inhibitor (CAI) and α-2 agonist agents (including treatments containing preservative agent). Cases 1 and 2 reported IOP values ≥23 mmHg in each eye, and wide IOP fluctuations were identified when reviewing patient data concerning case 3 (11–20 mmHg). Maximal therapy was ceased and PF tafluprost/timolol FC was initiated, after which the signs and symptoms of OSD were improved and IOP was reduced (≤18 mmHg for cases 1–3) and stabilized. Cases 4 and 5 were diagnosed with OAG and case 6 had OHT. Each had symptoms and signs of OSD and were treated with a preserved PGA monotherapy (latanoprost 0.005% or bimatoprost 0.03%). At presentation, IOP was 24 mmHg in both eyes (case 4), ≥18 mmHg (case 5) and ≥ 22 mmHg (case 6). Following a switch to the PF tafluprost/timolol FC, OSD symptoms were improved and IOP was 14 mmHg (both eyes; case 4), ≤14 mmHg (case 5) and 16 mmHg (both eyes; case 6).
Conclusions
In addition to IOP-lowering efficacy, approaches to the management of OAG and OHT should consider the impact of treatment tolerability and the susceptibility of these patients to OSD. The presence of ocular surface inflammation appears to be detrimental to adherence and therefore to the effectiveness of topical medications. Addressing OSD through the use of PF FC formations, such as the PF tafluprost/timolol FC, reduces exposure to potentially toxic agents and facilitates improvements in IOP control.
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Garcia-Medina JJ, Benitez-del-Castillo J, Rodríguez-Agirretxe I, Lopez-Lopez F, Moreno-Valladares A, Gimenez R, Parrilla Vallejo M, Anton lopez A, Torregrosa S, loscos J. Treatment of Open-Angle Glaucoma and Ocular Hypertension with Preservative-Free Tafluprost/Timolol Fixed-Dose Combination Therapy: Results from the VISIONARY Study Population in Spain. J Ocul Pharmacol Ther 2022; 38:252-260. [PMID: 35230148 PMCID: PMC9048172 DOI: 10.1089/jop.2021.0099] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose: Data are presented from ophthalmology clinics in Spain participating in the VISIONARY study, examining the effectiveness, tolerability, and safety of the preservative-free tafluprost (0.0015%) and timolol (0.5%) fixed-dose combination (PF tafluprost/timolol FC) in the treatment of OAG and OHT. Methods: An observational, multicenter prospective study examined treatment outcomes following a switch to PF tafluprost/timolol FC in adult OAG/OHT patients demonstrating insufficient response to beta-blocker or prostaglandin analog (PGA) monotherapy. Primary end point was mean change in intraocular pressure (IOP) from baseline at month 6. Changes in the severity of ocular signs and symptoms were also assessed. Results: Overall, 92 patients (51.1% female) were included. Mean (standard deviation) age was 68.3 (12.1) years. Mean IOP was reduced from 21.9 mmHg at baseline to 16.7 mmHg at month 6 (22.3% decrease; P < 0.0001). Significant IOP reductions were observed at weeks 4 and 12 (P < 0.0001). Baseline PGA and beta-blocker users demonstrated mean month 6 IOP reductions of 5.5 mmHg (23.5%; P < 0.001) and 3.5 mmHg (14.6%; P = 0.029), respectively. Severity of conjunctival hyperemia, dry eye, irritation, itching, foreign body sensation, and eye pain was significantly reduced. Three treatment-related adverse events were reported, all were nonserious and mild/moderate in severity. Conclusion: In real-world clinical practice, PF tafluprost/timolol FC treatment provided significant IOP reductions over 6 months and was well tolerated among OAG/OHT patients showing poor response to PGA or beta-blocker monotherapy. IOP-lowering efficacy and improvements in ocular signs and symptoms were evident from week 4 and maintained over the 6-month study period. Trial Registration: European Union electronic Register of Post-Authorisation Studies (EU PAS) register number EUPAS22204.
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Affiliation(s)
- Jose J. Garcia-Medina
- Department of Ophthalmology, Hospital General Universitario Morales Meseguer, Murcia, Spain.,Address correspondence to: Prof. Jose J. Garcia-Medina, Department of Ophthalmology, Hospital General Universitario Morales Meseguer, Avenida Marqués de los Vélez, s/n, Murcia 30008, Spain
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Oddone F, Kirwan J, Lopez-Lopez F, Zimina M, Fassari C, Holló G. Switching to Preservative-Free Tafluprost/Timolol Fixed-Dose Combination in the Treatment of Open-Angle Glaucoma or Ocular Hypertension: Subanalysis of Data from the VISIONARY Study According to Baseline Monotherapy Treatment. Adv Ther 2022; 39:3501-3521. [PMID: 35524840 PMCID: PMC9309126 DOI: 10.1007/s12325-022-02166-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/11/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The VISIONARY study demonstrated statistically significant intraocular pressure (IOP) reductions with the preservative-free fixed-dose combination of tafluprost 0.0015% and timolol 0.5% (PF tafluprost/timolol FC) in open-angle glaucoma (OAG) or ocular hypertension (OHT) patients, sub-optimally controlled with topical prostaglandin analogue (PGA) or beta-blocker monotherapy. Current subanalyses have examined these data according to the baseline monotherapy. METHODS A European, prospective, observational study included adults (aged ≥ 18 years) with OAG or OHT, who were switched to the PF tafluprost/timolol FC from PGA or beta-blocker monotherapy. Treatment outcomes were reported according to prior monotherapy subgroup: beta-blocker, preserved latanoprost, PF-latanoprost, bimatoprost, tafluprost, and travoprost. Endpoints included the mean change from baseline regarding IOP, conjunctival hyperemia, and corneal fluorescein staining (CFS) at Week 4 and Week 12, and at Month 6. RESULTS The subanalysis included 577 patients. All prior monotherapy subgroups demonstrated statistically significant IOP reductions from baseline at Week 4, that were maintained through Month 6 (p < 0.001). Mean (SD) IOP change at Month 6 was 6.6 (4.16), 6.3 (4.39), 5.6 (3.67), 4.9 (2.97), 4.6 (4.39), and 4.7 (3.64) mmHg for prior beta-blocker, preserved latanoprost, PF-latanoprost, tafluprost, bimatoprost, and travoprost subgroups, respectively. The largest IOP change was observed in the preserved latanoprost subgroup for each of the ≥ 20%, ≥ 25%, ≥ 30%, and ≥ 35% IOP reduction categories at Month 6, demonstrating respective reductions of 8.06, 9.20, 10.64, and 11.55 mmHg. CFS was significantly reduced at Month 6 in the prior bimatoprost subgroup (p = 0.0013). Conjunctival hyperemia severity was significantly reduced at each study visit for prior preserved latanoprost users (p < 0.001). CONCLUSION PF tafluprost/timolol FC therapy provided statistically and clinically significant IOP reductions from Week 4 over the total 6-month period, in patients with OAG/OHT, regardless of the type of prior PGA or beta-blocker monotherapy used. Conjunctival hyperemia severity and CFS decreased significantly in prior bimatoprost and preserved latanoprost users, respectively. CLINICAL STUDY NUMBER European Union electronic Register of Post-Authorization Studies (EU PAS) register number: EUPAS22204.
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Affiliation(s)
| | - James Kirwan
- Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Fernando Lopez-Lopez
- Instituto Oftalmologico Gomez-Ulla, Calle Maruxa Mallo 3 Santiago de Compostela, Galicia, Spain
| | | | | | - Gábor Holló
- Tutkimusz Ltd, Solymár, Hungary
- Eye Center, Prima Medica Health Centers, Budapest, Hungary
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Arfaee F, Armin A. A comparison between the effect of topical tafluprost and latanoprost on intraocular pressure in healthy male guinea pigs. J Exot Pet Med 2021. [DOI: 10.1053/j.jepm.2021.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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10
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Ansari E, Pavicic-Astalos J, Ayan F, King AJ, Kinsella M, Ng E, Nita A. Treatment of Open-Angle Glaucoma and Ocular Hypertension with Preservative-Free Tafluprost/Timolol Fixed-Dose Combination Therapy: UK and Ireland Results from the VISIONARY Study. Adv Ther 2021; 38:2990-3002. [PMID: 33886093 PMCID: PMC8190000 DOI: 10.1007/s12325-021-01725-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022]
Abstract
Introduction Reducing intraocular pressure (IOP), the only modifiable risk factor for open-angle glaucoma (OAG), is important for the preservation of vision and slowing of disease progression. Preservative-free tafluprost (0.0015%)/timolol (0.5%) fixed combination (PF Taf-T FC) is an approved combination therapy for OAG treatment. The VISIONARY study aimed to evaluate the effectiveness and tolerability of PF Taf-T FC in real-world clinical settings. Here, we present the results from the United Kingdom (UK) and Ireland. Methods This observational, multicentre, European, prospective study recorded data during routine clinic appointments on the use of PF Taf-T FC for the treatment of OAG and ocular hypertension (OHT) in patients whose disease was insufficiently controlled on a prostaglandin analogue (PGA) or beta blocker monotherapy or who did not tolerate these medications. Mean change in IOP, symptom severity, changes in clinical signs, and tolerability were investigated over 6 months. Results Eighty-two patients were recruited in the UK and Ireland. After 6 months of PF Taf-T FC treatment, mean IOP was significantly reduced from 22.0 to 16.2 mmHg in the UK group and from 18.6 to 14.1 mmHg in the Ireland group. In the UK (65 patients), 49 adverse events (AEs) were reported, of which 3 were serious. No AEs were reported in the Ireland group (17 patients). Overall, 91.9% of UK physicians reported PF Taf-T FC treatment to be the same or better than prior medication for improving clinical signs; 90.0% of UK patients reported PF Taf-T FC treatment to have good or very good tolerability. Conclusions Treatment with PF Taf-T FC resulted in significant reductions in mean IOP over 6 months. Patients and physicians reported that treatment was well tolerated. These data demonstrate real-world efficacy of PF Taf-T FC for the treatment of OAG and OHT in routine clinical practice in the UK and Ireland. Trial registration European Union electronic Register of Post-Authorisation Studies (EU PAS) register number, EUPAS22204. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01725-7.
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Affiliation(s)
- Ejaz Ansari
- Maidstone and Tunbridge Wells NHS Trust, University of Kent at Canterbury, Kent, UK.
| | | | | | - Anthony J King
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Matthew Kinsella
- Buckinghamshire Healthcare NHS Trust, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
| | - Eugene Ng
- Institute of Eye Surgery, UPMC Whitfield, Waterford, Ireland
| | - Anca Nita
- Royal Victoria Infirmary, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Shokoohimand A, Arfaee F, Asghari A, Khaksar E. Effects of topical administration of tafluprost and combination of tafluprost and timolol or tafluprost and betaxolol on Schirmer tear test, intraocular pressure, and pupil size in clinically healthy dogs. Int Ophthalmol 2020; 40:2585-2592. [PMID: 32504308 DOI: 10.1007/s10792-020-01439-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/22/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effects of 0.0015% preservative-free (PF) tafluprost alone and in combination with 0.5% timolol maleate or 0.5% betaxolol HCl on Schirmer tear test (STT), intraocular pressure (IOP), and pupil diameter (PD) in clinically normal dogs. METHODS Twenty-one healthy adult castrated male cross-bred dogs were used in this study. Dogs were randomly divided into three groups. The first group received one drop of (PF) tafluprost (Taf), in a randomly selected eye. The second group received one drop of (PF) tafluprost plus one drop of timolol maleate (Taf-Tim), and the last group received one drop of (PF) tafluprost plus one drop of betaxolol HCl, (Taf-Bet). In all groups, the fellow eyes were served as control and received one drop of saline as a placebo. IOP, STT, and PD measurements were performed at the baseline and every 30 min for the first 2 h, every 2 h for the next 10 h, and at 24 h and 36 h post-instillation (PI). RESULTS In all groups, significant differences in IOP values were observed between treated and untreated eyes (Taf: p < 0.001, Taf-Tim: p = 0.014, Taf-Bet: p = 0.008). The maximum reduction in mean IOP after unilateral administration of Taf, Taf-Tim, and Taf-Bet was 8.3 mmHg, 10.7 mmHg, and 13 mmHg, respectively. No significant differences in STT values were observed between treated and untreated eyes at any time points. In all groups, significant differences in PD values were observed between treated and untreated eyes in all time points except the baseline and 36 h post-drug instillation (p < 0.001). CONCLUSIONS Tafluprost alone or in combination with timolol and betaxolol was able to reduce intraocular pressure. The greatest effect of the drugs occurred 6 and 8 h PI. The present study revealed that the combination of tafluprost/betaxolol is more potent in decreasing IOP than tafluprost alone or a combination of tafluprost/timolol in healthy dogs.
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Affiliation(s)
- Armin Shokoohimand
- Department of Clinical Science, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University, Hesarak, Tehran, 1477893855, Islamic Republic of Iran
| | - Farnoosh Arfaee
- Department of Clinical Science, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University, Hesarak, Tehran, 1477893855, Islamic Republic of Iran.
| | - Ahmad Asghari
- Department of Clinical Science, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University, Hesarak, Tehran, 1477893855, Islamic Republic of Iran
| | - Ehsan Khaksar
- Department of Clinical Science, Faculty of Veterinary Sciences, Garmsar Branch, Islamic Azad University, Garmsar, 3581631167, Islamic Republic of Iran
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Konstas AG, Schmetterer L, Costa VP, Holló G, Katsanos A, Denis P, Quaranta L, Irkec M, Castejón MA, Teus MA, Robin AL. Current and emerging fixed combination therapies in glaucoma: a safety and tolerability review. Expert Opin Drug Saf 2020; 19:1445-1460. [DOI: 10.1080/14740338.2020.1826928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Anastasios G. Konstas
- 1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore; Academic Clinical Program, Duke-NUS Medical School, Singapore; SERI-NTU Advanced Ocular Engineering (STANCE), Singapore; Department of Clinical Pharmacology, Medical University of Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria; Institute of Clinical and Molecular Ophthalmology,
| | - Vital P. Costa
- Department of Ophthalmology, Universidade Estadual De Campinas, Campinas, Brazil
| | - Gábor Holló
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Andreas Katsanos
- Department of Ophthalmology, University of Ioannina, Ioannina, Greece
| | - Philippe Denis
- Department of Ophthalmology, Croix-Rousse University Hospital, Lyon, France
| | - Luciano Quaranta
- Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia-IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Murat Irkec
- Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Miguel A. Castejón
- Ophthalmology Department, University Hospital “Príncipe De Asturias”, Alcalá De Henares, Spain
| | - Miguel A. Teus
- Ophthalmology Department, University of Alcala, Madrid, Spain
| | - Alan L. Robin
- Wilmer Eye Institute and Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland, USA; Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA
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13
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Karlova EV, Petrov SY, Germanova VN. [Preservative-free fixed combination in the treatment of open-angle glaucoma and ocular hypertension: the VISIONARY Study (EUPAS22204)]. Vestn Oftalmol 2020; 136:76-84. [PMID: 32779459 DOI: 10.17116/oftalma202013604176] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Preservative-free fixed combination of 0.0015% Tafluprost and 0.5% Timolol (PF tafluprost/timolol FC) has demonstrated good antihypertensive effect and patient tolerance in randomized controlled clinical trials. PURPOSE To evaluate efficacy, tolerability, and safety of PF tafluprost/timolol FC in patients with primary open-angle glaucoma (POAG) and ocular hypertension (OH) who couldn't tolerate or gave insufficient response to topical beta-adrenoblockers or prostaglandin analogue monotherapy. MATERIAL AND METHODS The prospective multicenter European VISIONARY study (EUPAS22204) included 87 patients from 7 ophthalmological centers in Russia with mean age of 63.9±11.8. Primary endpoint was mean IOP change at month 6. The patients were monitored for changes in in the severity of ocular signs and symptoms. RESULTS Statistically significant (p<0.0001) reduction of mean IOP from baseline was seen at all study visits: 7.3±5.17 mmHg at week 4, 7.4±5.40 mmHg at week 12, and 7.1±5.10 mmHg at month 6. By month 6, IOP has decreased by 20; 25; 30 and 35% from baseline in 77.0%, 58.9%, 43.7%, and 31.0% of study patients, respectively. Conjunctival hyperemia was significantly reduced at all study visits. Significant reductions in dry eye symptoms (p<0.0010), irritation (p=0.0204) and itching (p=0.0010) were also observed. After 6 months on PF tafluprost/timolol FC, 85.7% of patients described it as easy or very easy to tolerate. CONCLUSION In clinical practice, PF tafluprost/timolol FC provided statistically significant IOP reductions in patients with POAG and OH insufficiently controlled by or intolerant to monotherapy with topical beta-adrenoblockers or a prostaglandin analogue. The highest IOP reduction was seen at week 4 and was maintained over the 6-month study period. There was also a decrease in the severity of symptoms of ocular surface condition.
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Affiliation(s)
- E V Karlova
- Samara Regional Clinical Ophthalmological Hospital named after T.I. Eroshevsky, Samara, Russia
| | - S Yu Petrov
- Research Institute of Eye Diseases, Moscow, Russia
| | - V N Germanova
- Samara Regional Clinical Ophthalmological Hospital named after T.I. Eroshevsky, Samara, Russia
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Shalaby WS, Shankar V, Razeghinejad R, Katz LJ. Current and new pharmacotherapeutic approaches for glaucoma. Expert Opin Pharmacother 2020; 21:2027-2040. [PMID: 32717157 DOI: 10.1080/14656566.2020.1795130] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Glaucoma is the leading cause of irreversible blindness worldwide. Medical therapy is the main line of treatment of open-angle glaucoma (OAG) and ocular hypertension. Despite the expansion of the glaucoma lineup with the newly approved medication classes, many barriers and issues still exist with topical therapy. Novel non-topical drug delivery may address such issues, adding more options to glaucoma pharmacotherapy. AREAS COVERED This review outlines current topical therapies for glaucoma, in addition to new medications under trials. The issues with topical therapy, in general, are discussed, as well as the new non-topical drug delivery systems. The authors performed a comprehensive search for published studies on glaucoma medical therapy using the electronic database of PubMed and manual search for each medication and non-topical delivery options. The extra- and intraocular delivery methods and the new topical glaucoma medications under research are covered. EXPERT OPINION Medical management of glaucoma represents a challenge for both patients and clinicians. Noncompliance (e.g. difficulty with administering the eye drops), cost, side effects, and intraocular pressure fluctuation are the major problems with topical therapy. To overcome such barriers, research should continue in developing new medications and innovation of non-topical drug delivery systems.
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Affiliation(s)
- Wesam Shamseldin Shalaby
- Glaucoma Research Center, Wills Eye Hospital , Philadelphia, PA, USA.,Tanta Medical School, Tanta University , Tanta, Gharbia, Egypt
| | - Vikram Shankar
- Glaucoma Research Center, Wills Eye Hospital , Philadelphia, PA, USA
| | - Reza Razeghinejad
- Glaucoma Research Center, Wills Eye Hospital , Philadelphia, PA, USA
| | - L Jay Katz
- Glaucoma Research Center, Wills Eye Hospital , Philadelphia, PA, USA
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Treatment of Open-Angle Glaucoma and Ocular Hypertension with Preservative-Free Tafluprost/Timolol Fixed-Dose Combination Therapy: The VISIONARY Study. Adv Ther 2020; 37:1436-1451. [PMID: 32072493 PMCID: PMC7140739 DOI: 10.1007/s12325-020-01239-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Indexed: 01/23/2023]
Abstract
Introduction A non-interventional, multicenter, European, prospective evaluation of the effectiveness, tolerability, and safety of a topical preservative-free tafluprost (0.0015%) and timolol (0.5%) fixed-dose combination (PF tafluprost/timolol FC) in adults with open-angle glaucoma (OAG) and ocular hypertension (OHT) demonstrating insufficient response to topical beta-receptor blockers or prostaglandin analogue (PGA) monotherapy. Methods Mean intraocular pressure (IOP) change from baseline was measured at study visits following a switch to PF tafluprost/timolol FC. Primary endpoint was absolute mean IOP change at month 6. Change from baseline concerning ocular signs and symptoms was also explored. Results Analyses included 577 patients (59.6% female). Mean age (SD) was 67.8 (11.67) years. Mean (SD) IOP reduction from baseline was significant at all study visits; 5.4 (3.76) mmHg (23.7%) at week 4, 5.9 (3.90) mmHg (25.6%) at week 12, and 5.7 (4.11) mmHg (24.9%) at month 6 (p < 0.0001 for all visits). At month 6, 69.2%, 53.6%, 40.0%, and 25.8% were responders based on ≥ 20%, ≥ 25%, ≥ 30%, and ≥ 35% cutoff values for mean IOP, respectively. Significant reductions were observed concerning corneal fluorescein staining (p < 0.0001), dry eye symptoms, irritation, itching, and foreign body sensation (p < 0.001 for each parameter). Conjunctival hyperemia was significantly reduced at all study visits (p < 0.0001 at each visit). Overall, 69 treatment-related adverse events (AEs) were reported, one of which was serious (status asthmaticus). Most AEs were mild to moderate in severity, and the majority had resolved or were resolving at the end of the study period. Conclusion In clinical practice, PF tafluprost/timolol FC provided statistically and clinically significant IOP reductions in patients with OAG and OHT insufficiently controlled on or intolerant to PGA or beta-receptor blocker monotherapy. The full IOP reduction appeared at week 4 and was maintained over the 6-month study period. Key symptoms of ocular surface health improved. Trial Registration European Union electronic Register of Post-Authorisation Studies (EU PAS) register number, EUPAS22204.
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Kurysheva NI. Assessment of the optic nerve head, peripapillary, and macular microcirculation in the newly diagnosed patients with primary open-angle glaucoma treated with topical tafluprost and tafluprost/timolol fixed combination. Taiwan J Ophthalmol 2019; 9:93-99. [PMID: 31198667 PMCID: PMC6557063 DOI: 10.4103/tjo.tjo_108_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
RELEVANCE: The ability of antiglaucoma drugs to improve ocular hemoperfusion is an important aspect of their action. Tafluprost is the first preservative-free prostaglandin analog. The efficacy and safety of tafluprost, as well as tafluprost/timolol fixed combination (FC), were demonstrated in randomized multicenter trials. However, there is no literature on the effect of tafluprost and its FC on the peripapillary and macular blood flow. PURPOSE: To determine the changes of microcirculation in the optic nerve head (ONH), peripapillary retina, and macula in patients with newly diagnosed primary open-angle glaucoma (POAG) under the topical tafluprost and tafluprost/timolol FC treatment. MATERIALS AND METHODS: Optical coherence tomography angiography (OCT-A) was performed in dynamics with an interval of a week in 36 patients (36 eyes) with a newly diagnosed initial stage of POAG: 12 eyes with tafluprost, 12 – tafluprost/timolol FC, and 12 – no topical treatment (the control group). The change in intraocular pressure (IOP), mean ocular perfusion pressure (MOPP) of the eye, and vessel density (VD) inside the ONH (inside disc), as well as in the peripapillary retina and macula, was evaluated by comparing paired repeated observations using the median growth analysis. RESULTS: In the tafluprost group, there were a decrease in IOP by 19.4% and an increase in MOPP by 8.7% from the reference level. In the tafluprost/timolol group, these figures were 43% and 30.1%, respectively. OCT-A values did not change reliably, except for VD inside disc: the median growth of the tafluprost group was 2.28 (P = 0.02) and of the tafluprost/timolol group was 1.82 (P = 0.03). These changes were obtained in 11 of 12 patients in each group under treatment. In control group, all indicators remained unchanged. CONCLUSIONS: A significant increase of MOPP and a decrease of VD in the ONH in patients with initial glaucoma occurred within a week under the topical tafluprost or its FC. This can be explained by the restoration of autoregulation of the ocular blood flow in conditions of pronounced hypotensive effect of the drugs.
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Affiliation(s)
- Natalia Ivanovna Kurysheva
- Consultative and Diagnostic Department of the Ophthalmological Center, Federal Medical and Biological Agency of the Russian Federation, Moscow 123098, Russian Federation.,A. I. Burnazyan Federal Medical and Biophysical Center, Federal Medical and Biological Agency of the Russian Federation, Moscow 123098, Russian Federation.,Department of Ophthalmological, Institute of Improvement of Professional Skill, Federal Medical and Biological Agency of the Russian Federation, Moscow 123098, Russian Federation
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Joh HJ, Jin SW. Comparison of different combinations of maximum medical therapy for lowering intraocular pressure in primary open angle glaucoma: 12-month retrospective consecutive case series. Jpn J Ophthalmol 2019; 63:322-327. [DOI: 10.1007/s10384-019-00673-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 04/09/2019] [Indexed: 11/25/2022]
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18
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Bourne RRA, Kaarniranta K, Lorenz K, Traverso CE, Vuorinen J, Ropo A. Changes in ocular signs and symptoms in patients switching from bimatoprost-timolol to tafluprost-timolol eye drops: an open-label phase IV study. BMJ Open 2019; 9:e024129. [PMID: 30944129 PMCID: PMC6500185 DOI: 10.1136/bmjopen-2018-024129] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Bimatoprost-timolol (bimatoprost 0.03%-timolol 0.5% fixed-dose combination [FDC]) and tafluprost-timolol (tafluprost 0.0015%-timolol 0.5% FDC) eye drops are currently the only topical intraocular pressure (IOP)-reducing therapies available as preservative-free (PF) prostaglandin and timolol FDC. The aim of this study was to investigate changes to ocular signs and symptoms when patients with ocular hypertension (OH) or open-angle glaucoma (OAG) switched from PF or benzalkonium chloride (BAK)-preserved bimatoprost-timolol to PF tafluprost-timolol eye drops. DESIGN This was a 12-week, open-label, phase IV study. SETTING Sixteen centres in Finland, Germany, Italy and the UK. PARTICIPANTS Patients with OH or OAG (IOP on medication ≤21 mm Hg), treated with PF or BAK-preserved bimatoprost-timolol for ≥4 weeks before screening, and presenting with conjunctival hyperaemia and ≥1 ocular symptom. INTERVENTIONS Patients were switched to PF tafluprost-timolol once daily in the treated eye(s). PRIMARY AND SECONDARY OUTCOME MEASURES The primary endpoints were change from screening to week 12 in conjunctival hyperaemia and worst ocular symptom. The secondary outcome measures were changes from screening in ocular signs (other than conjunctival hyperaemia) and symptoms at week 12. RESULTS Of 123 enrolled patients, 121 were included in the intention-to-treat dataset, of which all were Caucasian and 54.5% were female; 76 patients used BAK-preserved bimatoprost-timolol and 45 used PF drops. Conjunctival hyperaemia and severity of worst ocular symptom following switch to PF tafluprost-timolol significantly reduced from screening to week 12 in all patients (p<0.001). The percentage of patients with ocular signs and symptoms was significantly reduced at week 12 compared with screening (p<0.001). IOP was not affected by the change of treatment. CONCLUSIONS Switching from BAK-preserved or PF bimatoprost-timolol to tafluprost-timolol reduced both signs and symptoms of ocular surface disease with no clinically relevant effect on IOP. TRIAL REGISTRATION NUMBER EudraCT2014-005273-37; Results.
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Affiliation(s)
| | - Kai Kaarniranta
- Department of Ophthalmology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Katrin Lorenz
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Carlo Enrico Traverso
- Clinica Oculistica, Di.N.O.G.M.I., Università di Genova, and Ospedale Policlinico San Martino, Genova, Italy
| | | | - Auli Ropo
- Global Medical Affairs, Santen Oy, Helsinki, Finland
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Holló G, Katsanos A, Boboridis KG, Irkec M, Konstas AGP. Preservative-Free Prostaglandin Analogs and Prostaglandin/Timolol Fixed Combinations in the Treatment of Glaucoma: Efficacy, Safety and Potential Advantages. Drugs 2018; 78:39-64. [PMID: 29196953 DOI: 10.1007/s40265-017-0843-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Glaucoma therapy-related ocular surface disease (OSD) is a serious pathology with a broad spectrum of insidious clinical presentations and complex pathogenesis that undermines long-term glaucoma care. Preservatives, especially benzalkonium chloride (BAK), contained in topical intraocular pressure-lowering medications frequently cause or aggravate OSD in glaucoma. Management of these patients is challenging, and to date often empirical due to the scarcity of controlled long-term clinical trials. Most of the available data are extracted from case series and retrospective analysis. Preservative-free prostaglandins and prostaglandin/timolol fixed combinations are novel options developed to remove the harmful impact of preservatives, especially BAK, upon ocular tissues. Based on what is currently known on the value of preservative-free antiglaucoma therapies it is tempting to speculate how these new therapies may affect the future medical management of all glaucoma patients. This article provides a comprehensive and critical review of the current literature on preservative-free prostaglandins and preservative-free prostaglandin/timolol fixed combinations.
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Affiliation(s)
- Gábor Holló
- Department of Ophthalmology, Semmelweis University, Maria u. 39, Budapest, 1085, Hungary.
| | - Andreas Katsanos
- Ophthalmology Department, University of Ioannina, Ioannina, Greece
| | - Kostas G Boboridis
- Third Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Murat Irkec
- Department of Ophthalmology, Faculty of Ophthalmology, Hacettepe University, Ankara, Turkey
| | - Anastasios G P Konstas
- 1st University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,3rd University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Konstas AG, Katsanos A, Athanasopoulos GP, Voudouragkaki IC, Panagiotou ES, Pagkalidou E, Haidich AB, Giannoulis DA, Spathi E, Giannopoulos T, Katz LJ. Preservative-free tafluprost/timolol fixed combination: comparative 24-h efficacy administered morning or evening in open-angle glaucoma patients. Expert Opin Pharmacother 2018; 19:1981-1988. [DOI: 10.1080/14656566.2018.1534958] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anastasios-Georgios Konstas
- 1st University Department of Ophthalmology, Aristotle University , Thessaloniki, Greece
- 3rd University Department of Ophthalmology, Aristotle University , Thessaloniki, Greece
| | - Andreas Katsanos
- Department of Ophthalmology, University of Ioannina , Ioannina, Greece
| | | | | | | | - Eirini Pagkalidou
- Department of Hygiene, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | | | - Eleni Spathi
- 1st University Department of Ophthalmology, Aristotle University , Thessaloniki, Greece
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Inoue K, Ueda T, Ishida K, Tomita G. Efficacy and Safety of Switching from Tafluprost to a Tafluprost/Timolol Fixed Combination in Patients With Primary Open-Angle Glaucoma. Open Ophthalmol J 2018; 12:121-126. [PMID: 30069265 PMCID: PMC6047199 DOI: 10.2174/1874364101812010121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/20/2018] [Accepted: 05/24/2018] [Indexed: 11/22/2022] Open
Abstract
Background: The Tafluprost/Timolol Fixed Combination (TTFC) has demonstrated efficacy and safety in reducing Intraocular Pressure (IOP). However, direct comparisons of switching from tafluprost to TTFC are limited. Objective: To investigate the efficacy and safety of switching from tafluprost to TTFC in patients with Primary Open-Angle Glaucoma (POAG). Methods: Thirty-four eyes (34 patients) with POAG that did not achieve adequate IOP reduction on tafluprost were switched to TTFC with no washout period. IOP, systolic/diastolic blood pressure and pulse rate were measured 1 and 3 months later and compared with baseline values. All participants were asked about specific adverse reactions after 1 and 3 months of treatment. Patients also completed a questionnaire about preference and adherence after 1 month of treatment. Results: Mean IOP after 1 and 3 months was significantly lower than at baseline (14.2 ± 2.1 mmHg and 14.1 ± 2.3 mmHg, respectively, vs 16.0 ± 2.0 mmHg, P < 0.0001). Systolic/diastolic blood pressure and pulse rate were not significantly different from baseline after 1 and 3 months. The questionnaire indicated that the frequency of missing a dose was not different before (27.3%) or after (18.2%) switching to TTFC (P = 0.2371). There were five reports of adverse reactions (14.7%), including a corneal epithelium disorder, ocular irritation, skin irritation at the wrist, and chest pain. Two patients (5.9%) withdrew because of adverse reactions. Conclusion: Switching from tafluprost to TTFC achieved IOP control safely and was well accepted by patients.
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Affiliation(s)
| | | | - Kyoko Ishida
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Goji Tomita
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
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Inoue K, Kawashima T, Katakura S, Shidara K, Fujimoto T, Kohmoto H, Shiokawa M, Moriyama R, Okayama R. Switching from concomitant therapy to tafluprost/timolol fixed combination. Clin Ophthalmol 2018; 12:549-554. [PMID: 29606852 PMCID: PMC5868587 DOI: 10.2147/opth.s150595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the efficacy and safety of tafluprost/timolol fixed combination (TTFC). Study design A prospective clinical study. Methods Twenty-eight patients (28 eyes) with primary open-angle glaucoma, who had used tafluprost and timolol gel for at least 3 months with good adherence, were enrolled. Concomitant administration of tafluprost and timolol was switched to TTFC without a washout period. The intraocular pressure (IOP), blood pressure, pulse rate, and ocular signs were compared between before switching (baseline), and 4 and 8 weeks after switching. A questionnaire survey was also performed 4 weeks after switching to investigate ocular comfort and patient preferences. Results The IOP showed no significant change after switching to TTFC (14.8 ± 2.8, 14.6 ± 3.4, and 14.8 ± 3.7 mmHg at baseline, Week 4, and Week 8, respectively). The pulse rate and systolic blood pressure showed no changes, but diastolic blood pressure was significantly lower at Week 8. At baseline, fluorescein staining revealed corneal abnormalities in 3 patients, which resolved by Week 8 in 1 patient. Hyperemia was noted in 2 patients at baseline, and this also resolved by Week 8 in 1 patient. Three patients discontinued study treatment for the following reasons (1 patient each): blurred vision; ocular irritation, eyelid erythema, and asthenopia; and loss to follow-up from Week 8. The questionnaire survey revealed no significant differences between the 2 treatments, although more patients preferred TTFC. Conclusion Among 28 patients enrolled, only 2 patients discontinued the study treatment due to adverse reactions. In patients whose adherence was considered relatively good to concomitant therapy, switching to TTFC achieved similar IOP control with good safety and a high level of patient acceptance.
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Nakamoto K, Takeshi M, Hiraoka T, Eguchi M, Nakano Y, Otsuka N, Hizaki H, Akai H, Hashimoto M. The 24-hour intraocular pressure control by tafluprost/timolol fixed combination after switching from the concomitant use of tafluprost and timolol gel-forming solution, in patients with primary open-angle glaucoma. Clin Ophthalmol 2018; 12:359-367. [PMID: 29497276 PMCID: PMC5822853 DOI: 10.2147/opth.s152507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective The aim of this study was to evaluate the 24-hour intraocular pressure (IOP)-control effect of the tafluprost/timolol fixed combination (TAF/TIM-FC) in patients with primary open-angle glaucoma after they switched from the concomitant use of tafluprost and timolol gel-forming solution. Patients and methods Twenty patients with primary open-angle glaucoma (12 male and 8 female; mean ± SD age, 57.0±7.1 years) were included in this study. The patients were treated for 8 weeks with the concomitant administration of tafluprost and timolol gel-forming solution (evening dosing). At the end of this period, the patients underwent 24-hour IOP monitoring (measured at 21:00, 01:00, 05:00, 09:00, 13:00 and 17:00). IOP was measured with Goldmann applanation tonometer (GAT) and Icare PRO at sitting position at all timepoints and additionally, at supine position with Icare PRO tonometer at 01:00 and 05:00. The patients were then all switched to TAF/TIM-FC treatment (evening dosing). After 8 weeks, the 24-hour IOP monitoring was repeated. Results Nineteen patients completed the study. The mean 24-hour IOPs in the concomitant and TAF/TIM-FC phases were 13.8±2.7 vs 13.3±2.8 mmHg (P=0.0033) with the GAT in the sitting position and 13.96±2.56 vs 13.48±2.56 mmHg (P=0.0120) with the Icare PRO in habitual positions. In comparison with the concomitant phase, significantly lower IOP was observed for the TAF/TIM-FC phase at 21:00 and 01:00 with the GAT and at 01:00 with the Icare PRO. In addition, the maximum IOP and fluctuations in IOP in habitual positions were lower for the TAF/TIM-FC phase than for the concomitant phase. Conclusion TAF/TIM-FC showed a stable 24-hour IOP-lowering effect and was equally or more effective than the concomitant use of tafluprost and timolol gel, both when sitting and when in habitual positions.
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Affiliation(s)
- Kenji Nakamoto
- Department of Ophthalmology, Nippon Medical School, Tokyo, Japan
| | | | - Toshihiko Hiraoka
- Shinanozaka Clinic, Tokyo, Japan.,Hiraoka Eye Clinic, Saitama, Japan
| | - Mayuko Eguchi
- Shinanozaka Clinic, Tokyo, Japan.,Musashiurawa Eye Clinic, Saitama, Japan
| | - Yuichiro Nakano
- Department of Ophthalmology, Nippon Medical School, Tokyo, Japan.,Shinanozaka Clinic, Tokyo, Japan
| | - Naomi Otsuka
- Japan Medical Affairs, Global R&D, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Hiroko Hizaki
- Japan Medical Affairs, Global R&D, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Hiromi Akai
- Japan Medical Affairs, Global R&D, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Masayo Hashimoto
- Japan Medical Affairs, Global R&D, Santen Pharmaceutical Co., Ltd., Osaka, Japan
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Shin DH, Bae JH, Kim JM. The Effect of a Fixed Combination of 0.0015% Tafluprost-0.5% Timolol in Normal Tension Glaucoma Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.8.752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dae Hwan Shin
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Hun Bae
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Pillunat LE, Erb C, Ropo A, Kimmich F, Pfeiffer N. Preservative-free fixed combination of tafluprost 0.0015% and timolol 0.5% in patients with open-angle glaucoma and ocular hypertension: results of an open-label observational study. Clin Ophthalmol 2017; 11:1051-1064. [PMID: 28652689 PMCID: PMC5472425 DOI: 10.2147/opth.s128453] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Efficacy, tolerability and safety of the novel preservative-free fixed combination of tafluprost 0.0015%/timolol 0.5% (Taptiqom®) were investigated in an observational study in Germany. Objective To assess efficacy, tolerability and safety of the preservative-free fixed combination of tafluprost 0.0015%/timolol 0.5% in a real-life setting. Methods Intraocular pressure (IOP) was recorded for each eye at baseline (any previous therapy or untreated) and 4–16 weeks after changing medical treatment to or initiating treatment with the preservative-free fixed combination of tafluprost 0.0015%/timolol 0.5%. Change in IOP was evaluated over the study period for all patients and for specific pretreatment subgroups. Clinical signs such as conjunctival hyperemia and lid-parallel conjunctival folds (LIPCOF) were recorded using standardized comparative photographs. Corneal staining, subjective symptoms and local comfort were measured using a four-step scale. All adverse events were recorded. Results Among 1,157 patients enrolled, 1,075 patients were treated with the preservative-free fixed combination as the only medication at the final visit. Medical treatment was initiated in 741 patients because of an insufficient IOP-lowering effect of the prior medication. In 343 patients, medication was changed because of tolerability issues. The preservative-free fixed combination lowered IOP significantly in the subgroup of naïve patients, all subgroups with prior monotherapy and patients with prior fixed combinations: naïve patients: −8.9 mmHg, alpha- 2-agonists: −6.4 mmHg, beta-blockers: −5.7 mmHg, carbonic anhydrase inhibitors: −5.2 mmHg, prostaglandins: −4.7 mmHg, fixed-combination prostaglandins/timolol: −2.4 mmHg. At the final visit, clinical signs and subjective symptoms were improved in patients with prior medical therapy. Local comfort was rated as “very good” or “good” by 89.1% of patients at the final visit. Only few adverse events occurred during the treatment period. Conclusion The preservative-free fixed combination of tafluprost 0.0015%/timolol 0.5% was effective, well tolerated and showed a good safety profile.
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Affiliation(s)
- Lutz E Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden
| | - Carl Erb
- Augenklinik am Wittenbergplatz, Berlin, Germany
| | | | | | - Norbert Pfeiffer
- Department of Ophthalmology, Mainz University Medical Center, Mainz, Germany
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Kaarniranta K, Ikäheimo K, Mannermaa E, Ropo A. Pharmacokinetics, Efficacy, and Safety of the Preservative-free Fixed Combination of Tafluprost 0.0015% and Timolol 0.5% in Healthy Volunteers: A Phase I Comparison vs. the Corresponding Preservative-free Monotherapies. Clin Pharmacokinet 2016; 55:485-94. [PMID: 26391697 DOI: 10.1007/s40262-015-0331-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Plasma concentrations of tafluprost acid and timolol were compared after single (Day 1) and repeated (Day 8) instillations of once-daily tafluprost 0.0015%-timolol 0.5% preservative-free (PF) fixed-dose combination (FDC), once-daily PF tafluprost 0.0015%, and twice-daily PF timolol 0.5%. PATIENTS AND METHODS Fifteen healthy volunteers were randomized to this double-masked, single-center, three-period cross-over study. A wash-out interval of at least 4 weeks separated each three 8-day dosing period. Blood samples were drawn on the first and last day of each dosing period, prior to the morning dose, as well as 5, 10, 15, 30, and 45 min, and 1, 1.5, 2, 4, 8, and 12 h post-dosing. Sample plasma concentrations of tafluprost acid and/or timolol were determined and maximum concentration (C max), area under the concentration-over-time curve from time zero to the last time point with a quantifiable measurement (AUC0-last), and time to maximum concentration were calculated. Intraocular pressure (IOP), adverse events, and ocular/systemic safety variables were also evaluated. RESULTS Plasma concentrations of tafluprost acid were low, with similar levels measured subsequent to either single or repeated dosing of PF FDC and PF tafluprost. On both sampling days, concentrations peaked at 10 min after the dose, and were cleared from the blood circulation by 30 min; average C max ranged from 17 to 24 pg/mL, and AUC0-last from 3 to 5 pg*h/mL. Plasma concentrations of timolol were comparable after the first dose of PF FDC or PF timolol. Concentrations peaked at 15 min post-dose and diminished in a similar manner after 2 h; average C max was 800 pg/mL and AUC0-last 3900 pg*h/mL. As expected, PF timolol produced a higher Day 8 pre-dose timolol concentration than PF FDC (235 vs. 37 pg/mL; p < 0.001, respectively). The Day 8 post-dose changes in timolol concentrations were relative to this pre-dose difference. All study treatments were well tolerated and safe. PF FDC seemed to provide the best IOP reduction. CONCLUSIONS PF FDC demonstrated good IOP-lowering efficacy and displayed similar pharmacokinetic characteristics to the monotherapy agents. Exposure to timolol was reduced via the halved dosing.
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Affiliation(s)
- Kai Kaarniranta
- Department of Ophthalmology, University of Eastern Finland and Kuopio University Hospital, P.O. Box 100, FI 70029 KYS, Kuopio, Finland.
| | - Kirsi Ikäheimo
- Department of Ophthalmology, University of Eastern Finland and Kuopio University Hospital, P.O. Box 100, FI 70029 KYS, Kuopio, Finland
| | - Eliisa Mannermaa
- Department of Ophthalmology, University of Eastern Finland and Kuopio University Hospital, P.O. Box 100, FI 70029 KYS, Kuopio, Finland
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Pfennigsdorf S, Eschstruth P, Häsemeyer S, Feuerhake C, Brief G, Grobeiu I, Shirlaw A. Preservative-free bimatoprost 0.03%/timolol 0.5% fixed combination in patients with glaucoma in clinical practice. Clin Ophthalmol 2016; 10:1837-1846. [PMID: 27703324 PMCID: PMC5036566 DOI: 10.2147/opth.s106159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of this study was to evaluate the efficacy and tolerability of, and compliance to, preservative-free (PF), fixed-combination (FC) bimatoprost 0.03%/timolol 0.5% in patients with primary open-angle glaucoma or ocular hypertension in a clinical practice setting. Patients and methods This open-label study observed patients switched to PF FC bimatoprost 0.03%/timolol 0.5% due to insufficient intraocular pressure (IOP) control on previous therapies. IOP was measured at baseline and at ~12 weeks. Tolerability and continuation of therapy were also assessed. Results A total of 1,553 patients were included in the study, and the per-protocol population comprised 1,391 patients. There were some minor deviations from protocol: some patients with no prior therapy and some who switched for reasons other than insufficient IOP control were included in the analysis. The mean IOP was reduced by 27.4%, from 22.2 mmHg to 16.1 mmHg. In subgroup analyses, the mean IOP was significantly reduced from baseline, irrespective of whether previous treatment was monotherapy or combination therapy, and preserved or PF therapy. Physicians mostly (88.1%) reported the IOP-lowering efficacy of PF FC bimatoprost 0.03%/timolol 0.5% to be as expected or better than expected. Switching to PF FC bimatoprost 0.03%/timolol 0.5% resulted in reductions from baseline in the number of patients reporting ocular symptoms. Adverse events were reported by 6.2% of patients, the most common being eye irritation (1.6%) and eye pruritus (1.0%). Physicians reported treatment compliance as better or unchanged compared with prior treatment in almost all patients (93.9%). Most patients were expected to continue PF FC bimatoprost 0.03%/timolol 0.5% after the end of the study. Conclusion Switching to PF FC bimatoprost 0.03%/timolol 0.5% was associated with significant IOP reductions from baseline over 12 weeks. Adverse events were uncommon, and compliance was high compared with previous therapy. PF FC bimatoprost 0.03%/timolol 0.5% may be a suitable treatment for patients with inadequately controlled IOP or who are sensitive to preservatives.
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Konstas AGP, Holló G. Preservative-free tafluprost/timolol fixed combination: a new opportunity in the treatment of glaucoma. Expert Opin Pharmacother 2016; 17:1271-83. [DOI: 10.1080/14656566.2016.1182983] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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29
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New drugs and preparations for open-angle glaucoma in adults. Drug Ther Bull 2015; 53:141-144. [PMID: 26660437 DOI: 10.1136/dtb.2015.12.0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Primary (or chronic) open-angle glaucoma (POAG or COAG) may be asymptomatic but causes progressive optic nerve damage with significant loss of visual field. Treatments aim to lower intraocular pressure (IOP) by reducing the production of aqueous humour and/or increasing its drainage. Here we update our previous articles to reflect new drugs, preservative-free preparations and fixed-dose drug combinations for POAG.
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Sharma S, Trikha S, Perera SA, Aung T. Clinical effectiveness of brinzolamide 1%-brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension. Clin Ophthalmol 2015; 9:2201-7. [PMID: 26648686 PMCID: PMC4664487 DOI: 10.2147/opth.s72380] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The main first-line treatment strategy for glaucoma is to reduce intraocular pressure (IOP) by topical ocular hypotensive medications, but many patients require multiple medications for adequate IOP control. Fixed-combination therapies provide several benefits, including simplified treatment regimens, theoretical improved treatment adherence, elimination of the potential for washout of the first drug by the second, and the reduction in ocular exposure to preservatives. β-Adrenoceptor antagonists (particularly 0.5% timolol) are the most commonly used agents in combination with other classes of drugs as fixed-combination eyedrops, but they are contraindicated in many patients, owing to local allergy or systemic side effects. A fixed-combination preparation without a β-blocker is therefore warranted. This paper reviews the clinical effectiveness of brinzolamide 1% and brimonidine 0.2% fixed combination (BBFC) for use in patients with primary open-angle glaucoma and ocular hypertension. We searched PubMed and the ClinicalTrials.gov registry, and identified three randomized controlled trials comparing BBFC vs its constituents (brimonidine vs brinzolamide), and one comparing BBFC with unfixed brimonidine and brinzolamide. All of the studies demonstrated mean diurnal IOP to be statistically significantly lower in the BBFC group compared with constituent groups and noninferior to that with the concomitant group using two separate bottles. The safety profile of BBFC was consistent with that of its individual components, the most common ocular adverse events being ocular hyperemia, visual disturbances, and ocular allergic reactions. Common systemic adverse effects included altered taste sensation, oral dryness, fatigue, somnolence, and decreased alertness. BBFC seems to be a promising new fixed combination for use in glaucoma patients. However, long-term effects of BBFC on IOP, treatment adherence, and safety need to be determined.
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Affiliation(s)
- Sourabh Sharma
- Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore
| | - Sameer Trikha
- Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore
| | - Shamira A Perera
- Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore
| | - Tin Aung
- Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore ; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Akaishi T, Shimazaki A, Tonouchi A, Ueda K, Miyawaki N, Kawazu K. Benefits of Tafluprost and Timolol Fixed-Dose Combination for the Treatment of Glaucoma Are Confirmed by Studies on Experimental Animal Models. J Ocul Pharmacol Ther 2015; 31:518-24. [DOI: 10.1089/jop.2015.0031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Takahiro Akaishi
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Atsushi Shimazaki
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Asaka Tonouchi
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Kenji Ueda
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Nobuaki Miyawaki
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Kouichi Kawazu
- Research and Development Division, Santen Pharmaceutical Co., Ltd., Osaka, Japan
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33
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Holló G, Katsanos A. Safety and tolerability of the tafluprost/timolol fixed combination for the treatment of glaucoma. Expert Opin Drug Saf 2015; 14:609-17. [DOI: 10.1517/14740338.2015.1010507] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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34
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Holló G, Ropo A. Intraocular pressure decrease with preservative-free fixed and unfixed combination of tafluprost and timolol in pseudoexfoliative glaucoma. Curr Med Res Opin 2015; 31:13-6. [PMID: 25275411 DOI: 10.1185/03007995.2014.972500] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We investigated the intraocular pressure (IOP) lowering efficacy of preservative-free fixed and non-fixed combination of tafluprost 0.0015% and timolol 0.5% in pseudoexfoliative glaucoma (XFG). A per protocol worse eye analysis was made on all XFG patients who participated in a recent 6 month, prospective, randomized, double-masked, parallel group, multicenter phase III study. The mean time-wise IOP decreased by 8.62 to 10.25 mmHg (31.8 to 36.7%) in the fixed dose combination arm (15 patients) and by 5.38 to 11.35 mmHg (21.3 to 41.2%) in the non-fixed combination arm (13 patients), respectively (p < 0.001 for all comparisons). The results show that a preservative-free fixed dose combination of tafluprost and timolol provides a clinically significant IOP reduction in XFG, and may offer an advantage for the XFG patients with dry eye, due to its preservative-free nature.
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Affiliation(s)
- Gábor Holló
- Department of Ophthalmology, Semmelweis University , Budapest , Hungary
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35
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Pfeiffer N, Traverso CE, Lorenz K, Saarela V, Liinamaa J, Uusitalo H, Astakhov Y, Boiko E, Ropo A. A 6-month study comparing efficacy, safety, and tolerability of the preservative-free fixed combination of tafluprost 0.0015% and timolol 0.5% versus each of its individual preservative-free components. Adv Ther 2014; 31:1228-46. [PMID: 25447269 PMCID: PMC4271134 DOI: 10.1007/s12325-014-0163-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Indexed: 12/03/2022]
Abstract
Introduction The efficacy, safety and tolerability of the preservative-free (PF) fixed combination (FC) of tafluprost 0.0015% and timolol 0.5% (once daily) were compared to those of the individual components (PF tafluprost 0.0015% once daily and PF timolol 0.5% twice daily) in patients with open-angle glaucoma or ocular hypertension inadequately controlled on prior timolol or prostaglandin monotherapy for 6 months. Methods A stratified, double-masked, randomized, multicenter phase III study was conducted. A total of 189 prior timolol users were randomized within the timolol stratum (TS) to receive either FC (n = 95) or timolol 0.5% (TIM; n = 94). Furthermore, a total of 375 prior prostaglandin analog (PGA) users were randomized within the prostaglandin stratum (PS) to receive either FC (n = 188) or tafluprost 0.0015% (TAF; n = 187). To be eligible for participation in the study, the patients were required to have an intraocular pressure (IOP) of ≥22 mmHg when on timolol (TIM) or of ≥20 mmHg when on PGA in either treated eye at the screening and end-of-run-in visits. In addition to these, the study included visits at baseline, 2 and 6 weeks, 3 and 6 months and at a post-study visit. IOP was measured at 8 a.m., 10 a.m., 4 p.m., and 8 p.m. Results In the TS, a significant reduction from baseline IOP was seen with FC and TIM throughout the study. Average diurnal IOP change from baseline at month 3 was −8.55 mmHg (32%) for FC and −7.35 mmHg (28%) for TIM. The model-based treatment difference (FC–TIM) was −0.885 mmHg [95% confidence interval (CI) −1.745 to −0.024; p = 0.044] demonstrating the superiority of FC over TIM. In the PS, a significant reduction in IOP was seen with both FC and TAF throughout the study. The average diurnal IOP change from baseline at month 3 was −8.61 mmHg (33%) for FC and −7.23 mmHg (28%) for TAF. The model-based treatment difference (FC–TAF) was −1.516 mmHg (95% CI −2.044 to −0.988; p < 0.001) demonstrating the superiority of FC over TAF. In the TS, related ocular adverse events (AEs) were more frequent for patients treated with FC compared to TIM (16.8% versus 6.4%), whereas related non-ocular AEs were more frequent with TIM compared to FC (2.1% versus 0.0%). In the PS, AEs were similarly distributed between FC and TAF. The frequency of conjunctival hyperemia of FC was low (6.4%). Conclusion The preservative-free fixed combination of tafluprost and timolol provided a substantial and significant IOP reduction in both strata. The IOP reduction was superior to both tafluprost 0.0015% and timolol 0.5% when given as monotherapies. Overall, the study treatments were safe and well tolerated. Funding Santen Oy, Tampere, Finland. Electronic supplementary material The online version of this article (doi:10.1007/s12325-014-0163-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Norbert Pfeiffer
- Department of Ophthalmology, Mainz University Medical Center, Langenbeckstr. 1, 55101, Mainz, Germany,
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Actis AG, Rolle T. Ocular surface alterations and topical antiglaucomatous therapy: a review. Open Ophthalmol J 2014; 8:67-72. [PMID: 25317218 PMCID: PMC4192829 DOI: 10.2174/1874364101408010067] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 09/02/2014] [Accepted: 09/02/2014] [Indexed: 11/22/2022] Open
Abstract
Ocular Surface Disease (OSD) is prevalent among medically treated patients with glaucoma. This is basically related to three key-points: OSD and glaucoma are both prevalent in elderly and are common comorbidities in the same patient; the role of the active ingredient of the medical antiglaucomatous therapy; the role of the preservative agent of this medical therapy. Considering the actual state of literature we can state that the active glaucoma agent have a role in OSD, but the main cause seems to be the preservative agent, in particular referring to benzalkonium chloride, BAK. In the clinical evaluation of dry eye patients there is no actually established gold standard. Since the ocular surface injury not only causes dry eye, red eye, eye itching, photophobia and other discomforts, but also increases the risk of failure of glaucoma surgery in patients, it becomes fundamental a complete and good clinical evaluation of OSD (considering Schirmer’s test, tear breakup time, corneal and conjunctival staining) together with a good evaluation of patients’ quality of life (with validated questionnaires). Development of complex preparations, preservative-free and/or novel preservative preparations for glaucoma therapy could provide a promising approach in the prevention of ocular surface injuries.
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Affiliation(s)
- Alessandro G Actis
- University of Torino - Department of Surgical Sciences - Eye Clinic, Via Juvarra 19 - 10121 - Torino, Italy
| | - Teresa Rolle
- University of Torino - Department of Surgical Sciences - Eye Clinic, Via Juvarra 19 - 10121 - Torino, Italy
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Holló G, Vuorinen J, Tuominen J, Huttunen T, Ropo A, Pfeiffer N. Fixed-dose combination of tafluprost and timolol in the treatment of open-angle glaucoma and ocular hypertension: comparison with other fixed-combination products. Adv Ther 2014; 31:932-44. [PMID: 25213118 PMCID: PMC4177040 DOI: 10.1007/s12325-014-0151-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Indexed: 11/28/2022]
Abstract
A new preservative-free fixed-dose combination of 0.0015% tafluprost, a prostaglandin F2α analog, and 0.5% timolol (TAF/TIM; Santen Oy, Tampere, Finland), a beta-adrenergic antagonist has recently been developed. The intraocular pressure (IOP) reduction with TAF/TIM in open-angle glaucoma and ocular hypertension is similar to that of other prostaglandin–timolol fixed-combination products. Patients with high IOP responded well to TAF/TIM with reductions of up to 40% (>13 mmHg) and beyond. Compared to previous controlled and double-masked clinical trials with DuoTrav® (Alcon, Fort Worth, USA) and Ganfort® (Allergan, Irvine, USA), TAF/TIM caused less superficial ocular side effects and less conjunctival hyperemia. Plausible explanations for the differences in side effects between the fixed-combination products are discussed.
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Affiliation(s)
- Gábor Holló
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary,
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38
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Lorenz K, Pfeiffer N. Efficacy and safety of tafluprost 0.0015% and timolol maleate 0.5% fixed combination in patients with ocular hypertension or open-angle glaucoma. Expert Opin Pharmacother 2014; 15:2255-62. [DOI: 10.1517/14656566.2014.955471] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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39
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Holló G, Topouzis F, Fechtner RD. Fixed-combination intraocular pressure-lowering therapy for glaucoma and ocular hypertension: advantages in clinical practice. Expert Opin Pharmacother 2014; 15:1737-47. [DOI: 10.1517/14656566.2014.936850] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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