Efficacy of Single Glaucoma Medication in Combined Latanoprost and Timolol XE Therapy in Patients with Open-Angle Glaucoma and Ocular Hypertension: A Discontinuation Study

Kobayashi, Hiroshi

doi:10.1089/jop.2011.0127

Cited by 3 publications

(4 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the five articles included in the meta-analysis, all except Kobayashi [ 19 ] showed a return to baseline IOP following a washout of 3 or 4 weeks. Participants in the study by Kobayashi [ 19 ] continued on their other intraocular medications, while the other studies had participants discontinue their previous drops prior to the start of each study [ 18 – 22 ]. Stewart et al were the first to identify that there may be a variation in the time to return to baseline IOP following washout in individuals being treated with latanoprost.…”

Section: Resultsmentioning

confidence: 99%

“…Meta-analysis of existing literature demonstrated that after washout, IOP returned to baseline values, with a maximum of 17% IOP reduction (IOPR%) from baseline occurring at 4-weeks after washout. Of the eight articles which met the study criteria, the difference between baseline IOP (pretreatment) and postwashout IOP was statistically significant in only 3 studies [ 18 , 19 , 23 ]. A 4-week discontinuation of latanoprost in patients who had remained on beta-blockers and brinzolamide did not have an expected increase of 25–33% of pretreatment IOP, but only a 15.4% of baseline IOP increase.…”

Section: Discussionmentioning

confidence: 99%

“…As expected, the IOP did not return to baseline, as patients remained on at least one other IOP-lowering medication. This suggests that the effectiveness of PGAs is not as high as expected, especially in the setting of using multiple drug classes [ 14 , 19 ] (Stewart et al 2000). It is also possible that full responders, partial responders, and nonresponders to the PGA drug class were pooled in these studies, which the mean IOP values would not adequately reflect.…”

Section: Discussionmentioning

confidence: 99%

“…This review was limited by the number of available studies with published data. Only five studies had washout IOP as the main outcome measured [ 14 , 19 , 22 , 23 ], with only one study [ 19 ] publishing data that could be analyzed for PGAs. A majority of studies were crossover studies which included a discontinuation period.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Washout Duration of Prostaglandin Analogues: A Systematic Review and Meta-analysis

Diaconita

Quinn

Jamal

et al. 2018

Journal of Ophthalmology

View full text Add to dashboard Cite

Topic Prostaglandin analogues (PGAs) are first-line medical therapy for primary open angle glaucoma (POAG) and ocular hypertension (OHT). Intraocular pressure (IOP) lowering effects in full responders are known to be 25–33% for this class; however, partial responders and nonresponders do exist. In clinical trials or prospective series, discontinuation and washout of PGAs is necessary to evaluate true change in IOP from novel surgeries and medical therapies. Clinical Relevance To identify all relevant papers with pertinent data on washout of PGAs and quantify the duration and long-term effect of reported PGA washout periods in glaucoma and OHT patients. Methods A systematic review and meta-analysis was conducted to investigate the long-term effects on IOP after discontinuation of topical PGAs POAG and OHT patients. The main search was conducted in MEDLINE/PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, and BIOSIS Previews and conference proceedings. Results 1055 papers were identified, 548 were independently screened by two physicians., and 56 papers were analyzed for washout durations. The mean washout was found to be 4.56 weeks (±1.25), with the mode and median being 5 weeks. Five studies were analyzed as randomized control trials in which latanoprost was discontinued for 4 weeks prior to restarting another intraocular pressure-lowering drug. Meta-analysis revealed a 4-week discontinuation of latanoprost, on average, subjects returned to their baseline IOP. Conclusion A significant IOP-lowering effect of latanoprost was not observed beyond 4 weeks, suggesting this may be an appropriate washout period for latanoprost. We could not identify appropriate washout periods for either travoprost or bimatoprost, although a majority of articles had 4-week washout durations for the two drugs. Despite the widespread use of this class of medication, there is a paucity of literature on the effects of PGA washout in patients that are treatment naïve to other topical medications.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Washout Duration of Prostaglandin Analogues: A Systematic Review and Meta-analysis

Diaconita

Quinn

Jamal

et al. 2018

Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

Effectiveness of Intraocular Pressure–Lowering Medication Determined by Washout

et al. 2014

View full text Add to dashboard Cite

Intraocular pressure changes following topical ocular hypotensive medications washout

Daas

et al. 2020

Br J Ophthalmol

View full text Add to dashboard Cite

BackgroundTo review the changes in intraocular pressure (IOP) following topical hypotensive medications washout in patients with primary open angle glaucoma (POAG), ocular hypertension (OHT) and uveitic glaucoma (UG)/OHT.MethodsThe study included 120 patients with POAG, OHT and UG recruited from prospective clinical trials between February 2013 and July 2017. We excluded 20 eyes with IOP of ≤21 mm Hg, 11 eyes with previous incisional surgery and 17 eyes with incomplete data. UG eyes with active inflammation and on steroid treatment were excluded. Participants underwent a 1-month washout period from topical ocular hypotensive medications before IOP phasing. Comparisons were made between pre/post-washout IOP, and highest-recorded (peak) and post-washout IOP.ResultsA total of 110 eyes with POAG, 33 eyes with OHT and 43 eyes with UG were included for analysis. The mean pre-washout IOP was 18.1±3.3 mm Hg in POAG, 18.8±3.3 mm Hg in OHT and 17.9±8.8 mm Hg in UG; the mean post-washout IOP was 26.6±4.8 mm Hg, 26.4±3.9 mm Hg, 23.1±10.1 mm Hg in POAG, OHT and UG, respectively. The mean increase in IOP after washout was significantly lower in UG compared with POAG and OHT eyes (p=0.01). The percentage of eyes with post-washout IOP <22 mm Hg was 12.7% in POAG, 6.1% in OHT and 51.2% in UG.ConclusionActive inflammation and steroid treatment contributes to elevated IOP in uveitis. Therefore, IOP may revert to normal once inflammation subsides. We recommend ocular hypotensive treatment washout to be considered in UG eyes that have IOP under control in the absence of recurrence of uveitis.

show abstract

Efficacy of Single Glaucoma Medication in Combined Latanoprost and Timolol XE Therapy in Patients with Open-Angle Glaucoma and Ocular Hypertension: A Discontinuation Study

Abstract: There was a significant increase in IOP from discontinuation of timolol XE and latanoprost. The hypotensive effect of latanoprost in the combined drug therapy is significantly greater compared with timolol XE.

Cited by 3 publications

References 19 publications

Washout Duration of Prostaglandin Analogues: A Systematic Review and Meta-analysis

Washout Duration of Prostaglandin Analogues: A Systematic Review and Meta-analysis

Effectiveness of Intraocular Pressure–Lowering Medication Determined by Washout

Intraocular pressure changes following topical ocular hypotensive medications washout

Contact Info

Product

Resources

About