Clinical and Economic Impacts of Latanoprost 0.005% in First-Line Treatment of Open-Angle Glaucoma and Ocular Hypertension in France

Background/Aim There is increasing evidence for using selective laser trabeculoplasty as a first line treatment for chronic open angle glaucoma. The current first-line treatment is pharmacological therapy using eye drops. This study aims to assess the outcomes of selective laser trabeculoplasty in patients with glaucoma and ocular hypertension at a district general hospital and consider its role in reducing cost and treatment burden when treating patients with these conditions. Methods A single centre, retrospective case-note audit involving 58 eyes from 31 patients with a minimum follow-up of 4 months. Results Post selective laser trabeculoplasty, 62% had intraocular pressure <20 mmHg on latest follow up (36/58 eyes). Post selective laser trabeculoplasty, 10 patients (32%) were prescribed one fewer topical medication, while 20 patients (65%) were prescribed the same number of topical medications. Only 1 patient (3%) was prescribed one additional topical medication. Conclusion Selective laser trabeculoplasty is a safe and effective option for managing glaucoma and ocular hypertension. Selective laser trabeculoplasty may represent a cost-effective solution for healthcare providers as compared to pharmacological treatment.

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First-line treatment in open-angle glaucoma: an update

Expert Review of Ophthalmology ◽

10.1586/17469899.2013.855608 ◽

2013 ◽

Vol 8 (6) ◽

pp. 587-594 ◽

Cited By ~ 2

Author(s):

Suzanne A Turner ◽

Andrew I McNaught

Keyword(s):

Open Angle Glaucoma ◽

Line Treatment ◽

Open Angle ◽

First Line ◽

First Line Treatment

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Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial

The Lancet ◽

10.1016/s0140-6736(18)32213-x ◽

2019 ◽

Vol 393 (10180) ◽

pp. 1505-1516 ◽

Cited By ~ 85

Author(s):

Gus Gazzard ◽

Evgenia Konstantakopoulou ◽

David Garway-Heath ◽

Anurag Garg ◽

Victoria Vickerstaff ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Ocular Hypertension ◽

Controlled Trial ◽

Eye Drops ◽

Line Treatment ◽

Selective Laser Trabeculoplasty ◽

First Line ◽

Laser Trabeculoplasty ◽

Randomised Controlled ◽

First Line Treatment

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First-line latanoprost therapy in ocular hypertension or open-angle glaucoma patients: a 3-month efficacy analysis stratified by initial intraocular pressure

BMC Ophthalmology ◽

10.1186/1471-2415-10-4 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 7

Author(s):

Philippe Denis ◽

Christophe Baudouin ◽

Alain Bron ◽

Jean-Philippe Nordmann ◽

Jean Paul Renard ◽

...

Keyword(s):

Intraocular Pressure ◽

Ocular Hypertension ◽

Open Angle Glaucoma ◽

Open Angle ◽

First Line ◽

Efficacy Analysis

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PSS11 COST-EFFECTIVENESS ANALYSIS OF FORMULARY MANAGEMENT STRATEGIES FOR FIRST-LINE AGENTS USED IN OPEN-ANGLE GLAUCOMA AND OCULAR HYPERTENSION

Value in Health ◽

10.1016/j.jval.2011.02.313 ◽

2011 ◽

Vol 14 (3) ◽

pp. A55

Author(s):

D.A. Blaser ◽

M.M. Ousterhout ◽

J.M. Gagnon ◽

D. Calabrese

Keyword(s):

Cost Effectiveness ◽

Ocular Hypertension ◽

Open Angle Glaucoma ◽

Management Strategies ◽

Cost Effectiveness Analysis ◽

Open Angle ◽

First Line ◽

Effectiveness Analysis ◽

Formulary Management

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Naturalistic, Prospective Study of Glaucoma and Ocular Hypertension Treatment in France: Strategies, Clinical Outcomes, and Costs at 2 Years

European Journal of Ophthalmology ◽

10.1177/112067210501500507 ◽

2005 ◽

Vol 15 (5) ◽

pp. 562-580 ◽

Cited By ~ 14

Author(s):

J.-F. Rouland ◽

C. Le Pen ◽

H. Benhaddi ◽

E. Piriou ◽

H. Lilliu ◽

...

Keyword(s):

Ocular Hypertension ◽

Clinical Outcomes ◽

Adverse Drug Reactions ◽

Beta Blocker ◽

Open Angle Glaucoma ◽

Visual Field Defects ◽

Line Treatment ◽

Second Line ◽

Drug Reactions ◽

First Line

Purpose To prospectively observe second-line treatment strategies, their clinical outcomes, and treatment costs in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH) in France. Methods Second-line patients were recruited from September 14, 1998, to December 20, 2000, in 37 centers and were followed for up to 2 years. Outcomes were numbers of and reasons for treatment changes, changes in clinical parameters (intraocular pressure (IOP) levels, visual field defects, and optic nerve excavation), and direct medical costs associated with glaucoma management. This article reports results of the final analysis of 2-year follow-up data for patients with at least two contacts with a study ophthalmologist. Results Data were analyzed for 346 patients and 672 treated eyes. Monotherapy was used as first-line therapy in 92.0% of eyes. Second-line treatment was initiated an average of 2.8±0.2 years after diagnosis, primarily due to insufficient IOP control (60.3%) and adverse drug reactions (18.3%). Relative risk (RR) (95% CI) for adverse drug reactions (ADR) under monotherapy was 1.00 (1.00–1.00) under beta blockers (n=116) versus 0.40 (0.16–0.64) under latanoprost (n=21), 2.30 under carbonic anhydrase inhibitors (n=29), and 2.90 under adrenergics (n=38); RR for ADR under combination therapy was 1.00 (1.00–1.00) for unfixed combinations without latanoprost (n=66) versus 0.11 (0.00–0.22) for unfixed combinations of latanoprost + timolol (n=3). Cardiac or pulmonary problems have been reported in 26.9% of patients. Persistency on initial therapy was 62.5% (95% CI 53.0–72.0) for latanoprost monotherapy versus 41.1% (34.8–47.4) for beta-blocker monotherapy and 43.6% (26.6–60.6) for the latanoprost + timolol combination versus 29.8% (15.2–44.4) for combination therapies that did not include latanoprost. Average daily cost for latanoprost monotherapy was similar to that for patients who failed beta-blocker monotherapy: latanoprost + timolol did not cost more than therapeutic combinations without latanoprost. Conclusions Insufficient IOP control and adverse drug reactions are the two main reasons for changing first-line treatment in patients with POAG or OH. After 2 years, second-line treatment with latanoprost, as monotherapy or combined with timolol, provides superior safety and persistency to treatment at an acceptable cost.

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Topical Ripasudil as First Line Treatment for Ocular Hypertension in Uveitis Cases: AnAnalytic Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48878.14851 ◽

2021 ◽

Author(s):

Harvinder NagpaL ◽

Mandeep Kaur

Keyword(s):

Intraocular Pressure ◽

Ocular Hypertension ◽

Tertiary Care ◽

Eye Drops ◽

Care Hospital ◽

Line Treatment ◽

First Line ◽

Detailed Medical History ◽

Anti Inflammatory ◽

First Line Treatment

Introduction: Uveitis can directly or indirectly lead to ocular hypertension which can lead to glaucoma. Ripasudil has a different mechanism of action than other anti-glaucoma medications available commercially and in contrary to these drugs, ripasudil also has anti-inflammatory properties providing an upper edge over other intraocular pressure lowering drugs. In addition to primary glaucoma, these new Rho kinase associated inhibitors can provide satisfactory results in glaucoma with secondary pathologies. Aim: To study the role of ripasudil as first line treatment for ocular hypertension in uveitis cases. Materials and Methods: A prospective randomised study comprising 40 patients of Ocular Hypertension (OHT) associated with uveitis was conducted in the Outpatient Department (OPD) of Ophthalmology at a tertiary care hospital in North India from October 2020 to January 2021. The diagnosis of uveitis was made clinically with detailed medical history and slit lamp biomicroscopic examination. All the diagnosed patients were started with topical ripasudil hydrochloride hydrate 0.4% eye drops twice daily along with anti-inflammatory medications. Intraocular Presure (IOP) was recorded after 4 weeks and 12 weeks at 8 am, 10 am and 4 pm. Effectiveness of the drugs was calculated in terms of mmHg fall in mean intraocular pressure using t-test and p-values. Results: Out of 40 patients with uveitis associated OHT, 20caseswere inflammation related (mean age was 56.2±16.3years,13 males, 7 females) and 20 cases were categorised as corticosteroid induced (mean age was 58.9±15.69 years, 14 males, 6 females). At 12 weeks there was 5.67±0.59 mmHg fall in IOP (22.70%) in inflammation related OHT and there was 6.37±0.07 mmHg fall in IOP (25.34%) in corticosteroid related OHT. There was statistically significant fall in IOP (p-value=0.001). Conclusion: This study demonstrated that topical ripasudil hydrochloride hydrate 0.4% eye drops is effective in lowering the IOP, also there were no side effects, so it is safe and well-tolerated. So, ripasudil can provide a safe and effective alternative for lowering of IOP among uveitis related OHT.

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Faculty Opinions recommendation of Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.735320251.793560405 ◽

2019 ◽

Author(s):

Julian Garcia-Feijoo ◽

Federico Saenz-Frances

Keyword(s):

Randomised Controlled Trial ◽

Ocular Hypertension ◽

Controlled Trial ◽

Eye Drops ◽

Line Treatment ◽

Selective Laser Trabeculoplasty ◽

First Line ◽

Laser Trabeculoplasty ◽

Randomised Controlled ◽

First Line Treatment

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Netarsudil for the Treatment of Open-Angle Glaucoma and Ocular Hypertension: A Literature Review

Annals of Pharmacotherapy ◽

10.1177/1060028020971215 ◽

2020 ◽

pp. 106002802097121

Author(s):

Lipton E. Gonzalez ◽

Paul M. Boylan

Keyword(s):

Clinical Trials ◽

Literature Review ◽

Ocular Hypertension ◽

Kinase Inhibitors ◽

Open Angle Glaucoma ◽

Rho Kinase ◽

Open Angle ◽

First Line ◽

Aqueous Humor Outflow ◽

Rho Kinase Inhibitors

Objective: To evaluate netarsudil’s role as first-line therapy for the treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT). Data Sources: A literature search utilizing MEDLINE and CINAHL was performed using netarsudil and AR-13324 as keywords. Studies published from January 1970 to September 2020 were eligible. Study Selection and Data Extraction: For inclusion, articles were required to be published in English and participants enrolled in phase I, II, or III clinical trials. Articles were excluded if netarsudil was coformulated with another medication. Preclinical research, case reports, case series, review articles, citations without an abstract, and newsletters were excluded. Literature Review: The search retrieved 97 unique citations; 90 results were excluded, and 7 studies were included for analysis. Relevance to Patient Care and Clinical Practice: In all, 20 years elapsed between the Food and Drug Administration’s approvals of distinct medications to treat OAG. Existing first-line therapies target the uveoscleral pathway, which is responsible for a small amount of aqueous humor outflow. Rho kinase inhibitors target the trabecular pathway, which is responsible for 90% of aqueous humor outflow; thus, Rho kinase inhibitors may significantly reduce intraocular pressure and improve clinical outcomes for patients with OAG or OHT. Conclusions: Evidence demonstrates that netarsudil is inferior to prostaglandin analogues and noninferior to topical β-blockers in the treatment of OAG and OHT. Hyperemia is a common adverse drug reaction, which often resolves after medication discontinuation. Additional phase III clinical trials and evidence-based guidelines are necessary to determine netarsudil’s position in OAG and OHT management.

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