Fixed-combination treatments for intraocular hypertension in Chinese patients – focus on bimatoprost-timolol

Abstract

Glaucoma is a common eye disease that can lead to irreversible vision loss if left untreated. The early diagnosis and treatment of primary open-angle glaucoma is challenging, and visual impairment in Chinese glaucoma patients is a serious concern. Most of these patients need more than one topical antiglaucoma agent to control their intraocular pressures (IOPs). In the People’s Republic of China, the daily cost of different glaucoma medication varies greatly, and the treatment habits differ throughout the country. Prostaglandin analogs (PGAs) are recommended as first-line monotherapy, because of their efficacy and low risk of systemic side effects. Fixed-combination drops, particularly PGA-based fixed combinations, have recently been developed and used in patients with progression or who have failed to achieve their target IOPs. Here, we reviewed the current literature on the use of bimatoprost-timolol fixed combination (BTFC) in the People’s Republic of China. BTFC has achieved good efficacy and tolerability in Chinese clinical trials. In addition, BTFC is more cost effective compared with other fixed combinations available in the People’s Republic of China. Fixed-combination drops may offer benefits, such as keeping the ocular surface healthy, convenience of administration, and improvement in long-term adherence and quality of life. Therefore, BTFC has great potential for the treatment of Chinese glaucoma patients. However, the long-term efficacy of BTFC, comparisons of BTFC with other fixed-combination drugs, and treatment adherence and persistence with treatment in Chinese patients are unknown and will require further study.

Prescription trends for preservative free glaucoma medication in a public health system

“…Current clinical practice guidelines 1,12,13 establish PG analogues as the first therapeutic step for both POAG and ocular hypertension (OHT) due to their greater hypotensive effect 14 and fewer systemic adverse effects. 15 Correspondingly, in our study, PG analogues were the most commonly prescribed drugs in monotherapy (41.06% of prescriptions in 2020).…”

“…1,12,13 The current recommendation is, whenever possible, to use FCs given the greater convenience of dosing, instillation and the lower dose of preservatives. 15 This recommendation made FC the most frequently prescribed medicines during the seven years under study (48.99% of prescriptions in 2020).…”

Topical Medication Therapy for Glaucoma and Ocular Hypertension

“…BiT-FC has present in the market of more than 30 countries and regions worldwide OHT used for the reduction of IOP in patients with POAG ( Fang et al, 2015 ). BiT-FC significantly decreases IOP in a greater extent than PGA, or timolol monotherapy ( Lewis et al, 2010 ; Lequeu et al, 2013 ).…”

“…Although, the incidence of AEs is more in the bimatoprost-treated patients (60.0%) than in the BiT-FC- (48.0%) and timolol-treated patients (31.6%), it is acceptable. Conjunctival hyperemia is the most frequently observed AE, with an incidence of 43.4% by bimatoprost, followed by 25.7% of BiT-FC and 8.7% of timolol ( Fang et al, 2015 ).…”