Prostaglandin analogues: past, present, and future

[Comparison of the effectiveness and safety of glaucoma drugs in the therapy of primary open-angle glaucoma]

The rise in the number of glaucoma drugs complicates the choice that the ophthalmologists have to do.

PURPOSE

The study compares the effectiveness, safety and usability of the Russian latanoprost drug Trilaktan and the drug Xalatan in monotherapy for patients with primary open-angle glaucoma (POAG) and ocular hypertension (OH).

MATERIAL AND METHODS

This is a multicenter observational study of the effectiveness and safety of eye drops Trilaktan (Groteks, Russia) and Xalatan (Pfizer MFG. Belgium N.V., Belgium) in monotherapy for patients with POAG of early and moderate stages or OH. The maximum duration of the regimen for the studied drugs was 87 days. The study included 76 patients: 56 (74%) women and 20 (26%) men aged 50-84 years (mean age 66.3±1.3 years). The groups were homogeneous in demographic, anthropometric and vital indicators. Effectiveness was assessed by the trends in intraocular pressure (IOP) changes, safety - by analyzing the adverse events, usability and ease of use - by the questionnaires the study patients filled.

RESULTS

Both drugs investigated in this study decrease IOP by a mean of 6-8 mm Hg depending on tonometry method, with difference not exceeding 0.55 mm Hg. The proportion of patients with IOP decreased by 30% and more from the baseline level was 89.5% in both groups. The differences between the indicators of drug usability (by McMonnies conjunctival hyperemia scale, tear break-up time (TBUT), punctate keratopathy, OSDI questionnaire results) were insignificant, and the observed changes did not decrease the tolerability of the studied drugs. The patients using Trilaktan also commended the usability of the included eye drops dispenser.

CONCLUSIONS

The results of this study allow a conclusion that the effectiveness and safety of Trilaktan (Groteks, Russia) eye drops are equal to those of Xalatan (Pfizer MFG. Belgium N.V., Belgium) eye drops in patients with POAG of early and moderate stages or OH. Trilaktan is easy to use thanks to the included eye drops dispenser.

[Effectiveness and safety of drug combination therapy in patients with advanced primary open-angle glaucoma]

PURPOSE

To study the hypotensive effectiveness and safety of Bimoptic Plus (bimatoprost 0.03% + timolol 0.5%) in patients with developed primary open-angle glaucoma (POAG).

MATERIAL AND METHODS

The study included 30 patients aged 57 to 72 years (45 eyes). The 1^st group included 15 patients (24 eyes) who were first diagnosed with developed glaucoma with moderately elevated and high intraocular pressure (IOP) and prescribed the drug as starting therapy. Patients of the 2^nd group (15 patients, 21 eyes) were prescribed Bimoptic Plus with insufficient effectiveness of monotherapy with prostaglandin analogues. The follow-up period was 6 months.

RESULTS

The study was completed by 26 patients (41 eyes). Three patients (10%) has stopped using Bimoptic Plus due to side effects, one (3.3%) - due to insufficient hypotensive effect. In the 1^st group, the maximum IOP decrease was recorded at the 1^st month of the study and amounted to 8.34±1.47 mm Hg (32.2%) compared to baseline, while after 2 weeks, 3 and 6 months it decreased to 8.1±1.52 mm Hg (31.3%), 7.93±1.35 mm Hg (30.6%) and 7.9±1.42 mm Hg (30.5%), respectively. In patients of the 2^nd group, additional IOP decrease after 2 weeks, 1, 3, and 6 months from the start of therapy was 4.68±1.24 mm Hg (20.5%), 4.94±1.18 mm Hg (21.7%), 4.55±1.23 mm Hg (20%), 4.5±1.26 mm Hg (19.7%), respectively.

CONCLUSION

Bimoptic Plus effectively reduces the IOP level and has the least amount adverse reactions. It can be recommended for wide use in the treatment of patients with POAG.

[Efficacy and safety of travoprost in patients with primary open-angle glaucoma]

PURPOSE

To study the hypotensive efficacy and safety of Travapress (0.004% travoprost) in patients with primary open-angle glaucoma (POAG).

MATERIAL AND METHODS

The study included 50 patients (91 eyes) aged 45 to 74 years. The first group consisted of 23 patients (41 eyes) who received monotherapy with Travaprost. Patients of the second group (27 patients, 50 eyes) Travaprost was added to therapy with timolol 0.5% (17 patients, 32 eyes) or dorzolamide 2% (10 patients, 18 eyes). Travaprost was given for a period of 6 months. IOP was determined in 2 weeks, 1, 3 and 6 months from the beginning of treatment and daily IOP measurement was at 10.00, 12.00, 14.00 and 16.00. Subjective symptoms were evaluated in points by special scales.

RESULTS

The study was completed by 42 patients (84%, 79 eyes). Two patients (4.7%) has stopped to use Travapress due to the side effects. Local side effects were observed in 9 patients (21.4%) with mild hyperemia being the most common and seen in 5 patients (11.9%). In the first group, the maximum IOP decrease was recorded for 3 months of the study and amounted to 7.3±1.2 mm Hg (27.5%) compared to baseline. By 6 months, IOP decreased by 6.8±1.5 mm Hg on average (25.6%). In the second group in the subgroup with timolol 0,5% IOP decreased by 4,9±1.7 mm Hg (20%) compared to baseline, in the subgroup with dorzolamid 2% - by 4,3±1,3 mm Hg (16,9%) compared to baseline. Evening use the drug was accompanied by significantly lower levels of daily IOP fluctuations compared with morning intake (3.0±1.2 and 3.8±1.7 mm Hg, respectively, p = 0,002).

CONCLUSION

Travapress was established as highly efficient and safe. It can be recommended for wide use in the treatment of patients with POAG.