Benefits of switching from latanoprost to preservative-free tafluprost eye drops: a meta-analysis of two Phase IIIb clinical trials

Abstract

IntroductionGlaucoma patients frequently exhibit ocular surface side effects during treatment with prostaglandin eye drops. The present work investigated whether glaucoma patients suffering from signs and symptoms of ocular surface disease while using preserved latanoprost eye drops benefited from switching to preservative-free tafluprost eye drops.Patients and methodsThe analysis was based on 339 glaucoma patients enrolled in two Phase IIIb trials. The patients were required to have two symptoms, or one sign and one symptom of ocular surface disease at baseline, and at least 6 months preceding treatment with latanoprost eye drops preserved with benzalkonium chloride. All eligible patients were switched from latanoprost to preservative-free tafluprost for a total of 12 weeks. Ocular symptoms and ocular signs were evaluated at baseline and at 2 weeks, 6 weeks, and 12 weeks after commencing treatment with tafluprost. Intraocular pressure (IOP), drop discomfort, and treatment preference were evaluated to investigate the clinical efficacy and patient-related outcomes.ResultsAfter 12 weeks of treatment with preservative-free tafluprost, the incidences of irritation/burning/stinging, foreign body sensation, tearing, itching, and dry eye sensation had diminished to one-third of those reported for preserved latanoprost at baseline. The incidences of blepharitis and corneal/conjunctival fluorescein staining had in turn decreased to one-half of those reported for preserved latanoprost. Severity of conjunctival hyperemia was halved during treatment with preservative-free tafluprost, and there was significant improvement in tear break-up time and tear production. A further reduction in IOP (~1 mmHg) was seen with preservative-free tafluprost compared with preserved latanoprost. Drop discomfort was alleviated during preservative-free tafluprost treatment, and an outstanding majority of patients (72%) preferred preservative-free tafluprost over preserved latanoprost.ConclusionThis meta-analysis confirmed that IOP remained at the same level after replacing benzalkonium chloride-preserved latanoprost eye drops with preservative-free tafluprost eye drops. Preservative-free tafluprost significantly decreased the symptoms and signs of ocular surface disease and outrated latanoprost in drop comfort and treatment preference.

A comparative study of benzalkonium chloride-free latanoprost versus benzalkonium chloride-preserved latanoprost on ocular surface health in patients of primary open angle glaucoma

“…Statistically significant changes were observed for every symptom (p<0.05) except frequent blinking (p=0.291). Improvement in the frequency of symptoms with preservative free medication in glaucoma patients has also been reported by Pisella et al, Jaenen et al and Uusitalo et al [18][19][20] Results of the present study were in accordance with the results of previously conducted studies.…”

The Effects of Polyquad-Preserved Travoprost, Benzalkonium Chloride-Preserved Latanoprost, Purite-Preserved Brimonidine and Preservative-Free Tafluprost on Ocular Surface: A Rabbit Ocular Surface Study

“…19 BAK içeren latanoprost kullanan glokom hastalarının, prezervan içer-meyen tafluprosta geçişi ile oküler yüzey hastalığı bulguları ve kuru göz semptomlarında azalma olduğu izlenmiştir. 20 Benzer şekilde Walimbe ve ark., BAK içeren latanoprost kullanan hastalarda prezervan içermeyen latanoprosta geçiş sonrası göz-yaşı kırılma zamanı, oküler yüzey hastalığı indeksi, korneal boyanma ve konjonktival hiperemi skorlarında iyileşme olduğunu gözlemlemişlerdir. 21 Çalışmamızda, tafluprost uygulanan korneaların ışık mikroskopisi ile incelenmesinde genelde kontrol grubuna benzer değişiklikler gözlenmekle beraber, epitelin ondülasyon gösteren bazı bölge-lerinde incelmeler saptandı.…”

Impact of prostaglandin glaucoma drops on platelet-activating factor action: an in vitro study

“…It exhibits high affinity and selectivity with prostaglandin F prostanoid receptors, while it also binds to the prostanoid EP3 receptor, amplifying its hypotonic action 29,30. Kurashima et al supported that tafluprost limits ciliary artery contraction, inducing a superior hypotensive effect compared to latanoprost 31.…”