Efficacy and patient tolerability of travoprost BAK-free solution in patients with open-angle glaucoma and ocular hypertension

Abstract

The medical treatment of glaucoma has evolved significantly over the past several decades. The main driving forces behind this evolution are the safety profiles and efficacy of these medications. Prostaglandin (PG) analogues are shown to be superior to older drugs in both efficacy and tolerability. Though there are much fewer side effects that manifest after using PG analogues, the adherence and compliance to medication regimens are surprisingly lower than expected. A commonly sited reason is the ocular irritation and inflammation with these medications. Much of this inflammation can be attributed to the preservative, benzalkonium chloride (BAK). The chronic clinical and subclinical inflammation becomes increasingly detrimental when filtration surgery fails from bleb fibrosis secondary to this hypercellularity. A BAK-free formulation of a PG analogues recently became available. BAK-free travoprost is reviewed here. It has demonstrated equal efficacy and less ocular surface toxicity than its preserved counterparts. It is expected to serve as an instrumental resource in managing ocular hypertension and glaucoma in patients who demonstrate significant sensitivity to BAK. More randomized, controlled, double-blind studies are encouraged to evaluate its improved safety and tolerability.

Efficacy and safety of topical BAK-free travoprost 0.004% versus BAK-preserved travoprost 0.004% in the treatment of primary open angle glaucoma: a comparative study at a tertiary care hospital

“…In a literature review by Mirza SK et al, the author enumerates that BAK-free travoprost has demonstrated equal efficacy and less ocular surface toxicity than its preserved counterparts. 9 In the above study BAK-free travoprost demonstrated significant decrease in OSDI scores. These findings are in line with results of the study by Henry JC et al, wherein travoprost BAK-free demonstrated improved mean OSDI scores, decreased hyperaemia and equal or better IOP control compared to either latanoprost or bimatoprost.…”

“…This is in line with the observations made in previous studies. 8,9,18 The findings of this study have important implications for the medical management of patients with glaucoma, because OSD is common among glaucoma patients, and In choosing an IOP-lowering medication for glaucoma or ocular hypertension, both efficacy and tolerability should be considered. Given the far-reaching effects of ocular inflammation in regard to adherence and failure of filtration surgery, this advancement appears to be much needed.…”

“…SofZia is effective in microbicidal activity for up to 99% of microorganisms after an 8-day incubation, and it meets the antimicrobial criteria of the United States Pharmacopeia. 9 It is said to have equivalent IOP lowering capacity as BAK-preserved travoprost and less conjunctival hyperaemia.…”

Comparison of Efficacy and Safety Evaluation of Latanoprost Formulations with and without Benzalkonium Chloride

“…In recent years, as increasing attention has been paid to various ocular surface disorders, such as dry eye disease, conjunctivitis, allergies, and other problems that the preservatives contained in ophthalmic solutions may cause to ocular surface homeostasis, there is increasing demand for ophthalmic solutions that contain little or no preservatives [22]. Actually, clinical efficacy and safety profiles of BAK-free prostaglandin analogues have been well-documented, and their reduced ocular side effects have been indicated [23][24][25][26].…”

Efficacy and safety of travoprost alone or in combination with other agents for glaucoma and ocular hypertension: patient considerations

“…BAK-free travoprost was compared with latanoprost containing BAK preservative in patients with superficial punctate keratopathy. After replacing latanoprost containing BAK with travoprost containing SofZia, the score for superficial punctate keratopathy decreased significantly three months later 39,40…”