Taflotan, the first preservative-free prostaglandin F2α analogue: treatment advantages in primary open-angle glaucoma patients

Over the past 15 years, the negative role of toxic preservatives in the IOP-lowering eye drops solutions used in the treatment of primary open angle glaucoma (POAG) patients has been convincingly proven by many national and foreign experts. Therefore, there is a worldwide tendency to prescribe preferably preservative-free IOP-lowering eye drops nowadays. Taflotan is the world’s first preservative-free prostaglandin F2a analogue. In our study of POAG patients switched to Taflotan from the benzalkonium chloride-preserved latanoprost eye drops, we observed a marked decrease in corneal staining and severity of conjunctival hyperemia, as well as increase of the tear breakup time and corneal epithelium morphology improvement evaluated by confocal tomography. Thus, the drug not only effectively lowers IOP but also produces less negative effect on the tear film and eyeball surface, improving treatment tolerability.

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Preservative-Free Latanoprost Eye Drops in Patients with Primary Open-Angle Glaucoma/Ocular Hypertension

Clinical Drug Investigation ◽

10.1007/s40261-014-0203-4 ◽

2014 ◽

Vol 34 (7) ◽

pp. 521-528 ◽

Cited By ~ 18

Author(s):

Mark Sanford

Keyword(s):

Ocular Hypertension ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Eye Drops ◽

Open Angle ◽

Preservative Free

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Extracellular MMP-9-Based Assessment of Ocular Surface Inflammation in Patients with Primary Open-Angle Glaucoma

Journal of Ophthalmology ◽

10.1155/2019/1240537 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Anna Zaleska-Żmijewska ◽

Ewa Strzemecka ◽

Zbigniew M. Wawrzyniak ◽

Jacek P. Szaflik

Keyword(s):

Disease Severity ◽

Ocular Surface ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Ocular Inflammation ◽

Eye Drops ◽

Open Angle ◽

Surface Inflammation ◽

Preservative Free ◽

Ocular Surface Inflammation

Purpose. Objective assessment of dry eye disease (DED) severity and ocular inflammation using the InflammaDry® test for extracellular matrix metalloproteinase-9 (MMP-9) and the impact of antiglaucoma eye drops in people with primary open-angle glaucoma (POAG). Methods. Overall, 90 adults (180 eyes) were included: 60 had been diagnosed with POAG and were treated with prostaglandin analogue monotherapy and 30 were suspected of having POAG but did not receive any treatment (control group). Of those treated with prostaglandin eye drops, 30 received a preservative-free formulation (tafluprost) and 30 were treated with a formulation containing the preservative benzalkonium chloride (BAK) (latanoprost). Measurement of extracellular MMP-9 levels (InflammaDry test) provided a marker for ocular surface inflammation. Further assessments of disease severity and inflammation comprised Goldmann applanation tonometry for intraocular pressure (IOP), Schirmer’s test with anesthesia, ocular surface staining with unpreserved fluorescein (Oxford scale index), tear breakup time (TBUT), McMonnies questionnaire, and the Ocular Surface Disease index (OSDI). Results. Clinically significant MMP-9 levels (>40 ng/mL) were detected in tear film from 46.7% of subjects treated with BAK-containing medication. In contrast, only 16.7% of subjects treated with preservative-free medication or untreated individuals demonstrated similar MMP-9 levels. This difference was statistically significant (p<0.05). MMP-9 results correlated with other indicators of inflammation and disease severity. BAK-containing medication was associated with rapid TBUT (<5 seconds) in 50% of cases, while only 10% of untreated subjects and individuals using preservative-free medication demonstrated comparable TBUT results. Conclusion. Measurement of ocular surface MMP-9 level provides a useful marker for inflammation and DED in POAG. Use of a preservative-free topical prostaglandin formulation results in lower levels of ocular inflammation, compared with BAK-containing medication.

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Topical Bimatoprost Insert for Primary Open-Angle Glaucoma and Ocular Hypertension Treatment - A Phase II Controlled Study

Current Drug Delivery ◽

10.2174/1567201818666210101112256 ◽

2021 ◽

Vol 18 ◽

Author(s):

Francine Rubião ◽

Alan Cezar Faria Araújo ◽

João Bernardo Sancio ◽

Bárbara Silva Nogueira ◽

Juçara Ribeiro Franca ◽

...

Keyword(s):

Ocular Hypertension ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

T Test ◽

Controlled Study ◽

Therapeutic Drug ◽

Eye Drops ◽

Open Angle ◽

Drug Concentrations

Background: The most common treatment for primary open-angle glaucoma (POAG) is the daily use of eye drops. Sustained-release drug delivery systems have been developed to improve patient adherence by achieving prolonged therapeutic drug concentrations in ocular target tissues while limiting systemic exposure. The purpose of this study is to compare the efficacy and safety of bimatoprost inserts with bimatoprost eye drops in patients with POAG and ocular hypertension (OH). Methods: We include OH and POAG patients aged between 40 and 75 years-old. Both OH and POAG patients had intraocular pressure (IOP) greater than 21 and ≤30 mmHg at 9:00 am without glaucoma medication and normal biomicroscopy. Five normal patients with IOP≤14 mmHg constitute the control group. A chitosan-based insert of bimatoprost was placed at the upper conjunctival fornix of the right eye. In the left eye, patients used one drop of LumiganTM daily at 10:00 pm. For statistical analysis, we used a two-way analysis of variance (ANOVA), Student t-test, and paired t-test. Results: Sixteen POAG and 13 OH patients with a mean age of 61 years were assessed. In both eyes, IOP reduction was similar during three weeks of follow-up (19.5±2.2 mmHg and 16.9±3.1 mmHg), insert, and eye drop, respectively; P=0.165). The percentage of IOP reduction in the third week was 30% for insert and 35% for eye drops (P=0.165). No intolerance or discomfort with the insert was reported. Among the research participants, 58% preferred the use of the insert while 25% preferred eye drops, and 17% reported no preference. Conclusions: Bimatoprost-loaded inserts showed similar efficacy to daily bimatoprost eye drops during three weeks of follow up, without major side effects. This might suggest a possible change in the daily therapeutic regimen for the treatment of POAG and OH.

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A Comparative Analysis of the Efficacy and Safety of fixed Combinations of Latanoprost/Timolol vs Dorzolamide/Timolol in Primary Open Angle Glaucoma or Ocular Hypertension

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1039 ◽

2012 ◽

Vol 46 (4) ◽

pp. 172-176

Author(s):

Sukhsagar Ratol ◽

Rani Walia ◽

Mridu Chaudhry

Keyword(s):

Ocular Hypertension ◽

Primary Open Angle Glaucoma ◽

Fixed Combination ◽

Open Angle Glaucoma ◽

Eye Drops ◽

Open Angle ◽

Once Daily ◽

Group 2 ◽

Diurnal Iop ◽

Group 1

ABSTRACT Background Glaucoma is a leading cause of irreversible blindness. The fundamental problem in medical management of glaucoma is of patient compliance. An ideal drug or a drug combination is needed to slow the progression of this majorly symptomless disease. Aim To compare the efficacy and tolerability of the fixed combination latanoprost and timolol instilled once daily in the evening vs fixed combination of dorzolamide and timolol instilled twice daily in primary open angle glaucoma or ocular hypertension. Materials and methods A 12-week, randomized, open, parallel group study including 50 patients with primary open angle glaucoma or ocular hypertension was conducted at a tertiary care hospital. Patients were randomized to group 1, (fixed combination (FC) latanoprost and timolol eye drops, once daily in evening) and group 2, (FC dorzolamide and timolol eye drops, twice daily). At baseline, 2, 4 and 12 weeks, IOP was recorded at 9 AM and 12 noon. The difference in IOP reduction in two treatment groups from baseline to 12 weeks was the main outcome measure. Results Mean diurnal IOP was similar at baseline for both groups. Mean reduction in IOP from baseline to 12 weeks was 9.92 mm Hg (p = 0.001) in group 1 and 9.22 (p = 0.001) in group 2. The reduction in IOP in both groups 1 and 2 was statistically significant at all time intervals. There was a statistically significant advantage for group 1 at 12 weeks for both time readings (p = 0.013 and 0.002 respectively) as compared to group 2. Conclusion The fixed combination of latanoprost and timolol was more effective than that of dorzolamide and timolol in reducing mean diurnal IOP and both treatments were well tolerated. To confirm further such studies are required. How to cite this article Ratol S, Walia R, Chaudhry M. A Comparative Analysis of the Efficacy and Safety of fixed Combinations of Latanoprost/Timolol vs Dorzolamide/Timolol in Primary Open Angle Glaucoma or Ocular Hypertension. J Postgrad Med Edu Res 2012;46(4):172-176.

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Preservative-free versus preserved latanoprost eye drops for reducing intraocular pressure: a non-inferiority phase III randomized, multi-center, single-blind, parallel-group controlled trial

Medical hypothesis discovery and innovation in ophthalmology ◽

10.51329/mehdiophthal1413 ◽

2021 ◽

Vol 9 (4) ◽

Author(s):

Panos Theodosiadis ◽

Anastasios Konstas ◽

Ioannis Halkiadakis ◽

Vasiliki Dimera ◽

Dimitrios Koufakis ◽

...

Keyword(s):

Intraocular Pressure ◽

Ocular Hypertension ◽

Open Angle Glaucoma ◽

Ophthalmic Solution ◽

Phase Iii ◽

Point Estimate ◽

Eye Drops ◽

Open Angle ◽

Parallel Group ◽

Preservative Free

Background: The aim of this study was to test the non-inferiority of preservative-free (PF) latanoprost 50 μg/mL multi-dose ophthalmic solution versus the marketed benzalkonium chloride (BAK)-preserved latanoprost 50 μg/mL ophthalmic solution in patients with open-angle glaucoma and patients with ocular hypertension. Methods: This was a prospective, national, randomized, multi-center, observer-blind, parallel-group controlled clinical trial. Patients were randomized to receive either PF or BAK-preserved latanoprost once daily for 12 weeks. The primary endpoint was the change in intraocular pressure (IOP) at 8:00 AM in the affected eye between the end of the treatment (week 12) and the baseline (week 0). Secondary measurements were taken at weeks 2 and 6, with IOP being recorded at 8:00 AM, 12:00 PM, and 4:00 PM. Results: A total of 158 patients were included in the per protocol (PP) population (77 in the PF latanoprost treatment arm and 81 patients in the BAK-preserved latanoprost treatment arm). PF latanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP at 8:00 AM in the study eye from the baseline (week 0) to the end of the treatment (week 12). The point estimate of the between-treatment difference was 0.1 mmHg (95% confidence interval: -0.646, 0.847). Mean between-group differences in IOP reduction from the baseline to each of the secondary measurements were also similar between the two treatment arms. The two treatments were well tolerated and had comparable adverse event profiles. Conclusions: PF latanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP in patients with open-angle glaucoma or ocular hypertension. Both treatments were well tolerated.

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The clinical feature of myocilin Y437H mutation in a Chinese family with primary open-angle glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313069 ◽

2019 ◽

Vol 103 (10) ◽

pp. 1524-1529

Author(s):

Lei Lei ◽

Shushan Li ◽

Xiangyun Liu ◽

Chun Zhang

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Clinical Feature ◽

Visual Field Defects ◽

Chinese Family ◽

Eye Drops ◽

Open Angle ◽

Age Related ◽

Phenotypic Characterisation ◽

The Mean

PurposeTo characterise the genotype(s), phenotype(s) and age-related penetrance of glaucoma in a Chinese family with primary open-angle glaucoma (POAG).MethodsRecruited from a Chinese family spanning four generations, 7 individuals with POAG, 1 with ocular hypertension (OHT) and 14 unaffected individuals were included in this study. Genotypic investigation included sequencing of mutation sites using a glaucoma panel in combination with high-throughput sequencing and validated using Sanger sequencing. Phenotypic characterisation included investigation into patient medical history and physical examination.ResultsEight (36.4%) family members harboured heterozygous Y437H mutation, of whom seven (87.5%) were glaucomatous and one (12.5%) had OHT. The mean age of POAG diagnosis was 30.85±7.13 years. The mean highest recorded intraocular pressure (IOP) was 46.57±6.53 mm Hg. They all had complained of symptoms associated with vision and pain. Four (57.1%) patients presented blindness. Five eyes (62.5%) presented with severe and three eyes with moderate visual field defects. Most of them underwent surgery on average 1.29±2.36 years after diagnosis, and the mean IOP at study was 17.95±7.23 mm Hg, with an average of 0.92±0.86 eye-drops. The patient with OHT was treated with latanoprost only and her IOP was well controlled. Age-related glaucoma penetrance was 0% in individuals under the age of 20 years, 50% at ages 20–35 years, 75% at ages 31–35 years and 87.5% over 45 years.ConclusionA novel MYOC mutation (c.1309T>C, p.Y437H) in a Chinese family with POAG was identified which was associated with a phenotype characterised by severe visual impairment, frequent surgical intervention requirement and relatively high penetrance.

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Managing Primary Open-angle Glaucoma – Ocular Tolerability, Compliance, Persistence and Patient Outcomes

European Ophthalmic Review ◽

10.17925/eor.2009.03.01.19 ◽

2009 ◽

Vol 03 (01) ◽

pp. 19 ◽

Cited By ~ 2

Author(s):

Anton Hommer ◽

Keyword(s):

Adverse Effects ◽

Patient Compliance ◽

Vision Loss ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Tolerability Profile ◽

Eye Drops ◽

Open Angle ◽

The Individual ◽

Ocular Tolerability

Primary open-angle glaucoma (POAG) is a progressive optic neuropathy that, left untreated, can lead to irreversible damage to the optic nerve and permanent vision loss. To date, intraocular pressure (IOP) is the only modifiable risk factor for disease progression, and topical eye-drops are currently used as the leading non-surgical glaucoma therapy. Despite the efficacy of pharmacotherapy in lowering IOP, success is ultimately defined by patient compliance and patient persistence. Ocular tolerability is a crucial factor in patient compliance and persistence; non-adherence owing to adverse effects can lead to poor control of IOP and treatment failure. Prostaglandin analogues are currently the first-line antiglaucoma agents, with a good tolerability profile and a better IOP-lowering effect compared with β-blockers. Combination therapies have also shown greater efficacy in lowering IOP compared with the individual constituents, with fewer adverse effects. Treatment should be tailored to the individual patient, with a focus on ocular tolerability and its role in adherence, compliance and vision preservation.

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