Ocular Hypotensive Effects and Safety over 3 Months of Switching from an Unfixed Combination to Latanoprost 0.005%/Timolol Maleate 0.5% Fixed Combination

Inoue, Kenji; Okayama, Ryoko; Higa, Risako; Sawada, Hideko; Wakakura, Masato; Tomita, Goji

doi:10.1089/jop.2011.0057

Cited by 21 publications

(29 citation statements)

References 16 publications

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“…Drug washout during concomitant administration of multiple medications44 and low adherence and persistence with complex glaucoma therapeutic regimens22,24,27 may reduce the effectiveness of multidrug regimens. Fixed-combination medications prevent drug washout, simplify dosing regimens, and may reduce costs,92 thereby potentially increasing medication adherence21,51,93,94 and persistence 20,21. BBFC provides IOP-lowering efficacy greater than or similar to various monotherapy and fixed-combination medications, with potentially improved convenience and better tolerability.…”

Section: Resultsmentioning

confidence: 99%

“…For example, when patients were switched from separate administration of latanoprost 0.005% and timolol 0.5% to a fixed combination of latanoprost 0.005%/timolol 0.5%, the percentage of patients who reported never missing a dose was significantly greater after the switch (71.0%) compared with before the switch (59.3%; P =0.0115) 51. Because adherence relies on patients’ willingness to take their medication, it is important that patients prefer the medication they are prescribed over other equally efficacious alternatives.…”

Section: Introductionmentioning

confidence: 99%

“…Prospective trials have shown that switching from concomitant administration of multiple separate medications to a fixed-combination therapy increases patient adherence 50,51. For example, when patients were switched from separate administration of latanoprost 0.005% and timolol 0.5% to a fixed combination of latanoprost 0.005%/timolol 0.5%, the percentage of patients who reported never missing a dose was significantly greater after the switch (71.0%) compared with before the switch (59.3%; P =0.0115) 51.…”

Section: Introductionmentioning

confidence: 99%

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Combination of brinzolamide and brimonidine for glaucoma and ocular hypertension: critical appraisal and patient focus

Nguyen

2014

PPA

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Glaucoma is one of the leading causes of blindness and is characterized by optic nerve damage that results in visual field loss. Elevated intraocular pressure (IOP) has been associated with glaucoma progression; thus, IOP-lowering medications are the standard of care for glaucoma. Guidelines suggest monotherapy with IOP-lowering agents such as β-blockers (eg, timolol), prostaglandin analogs, carbonic anhydrase inhibitors (eg, brinzolamide), and α2-receptor agonists (eg, brimonidine). However, monotherapy may provide insufficient IOP reduction in some patients, thereby necessitating the use of multiple IOP-lowering medications. Multidrug regimens may be complex, may increase the risk of preservative-related ocular symptoms, and may potentially reduce overall drug exposure as a consequence of drug washout during closely timed sequential administrations; these difficulties may reduce overall drug efficacy and decrease patient persistence and adherence with multidrug treatment regimens. Fixed-combination medications that provide two IOP-lowering therapies within a single solution are available and may overcome some of these challenges. However, all currently available fixed combinations combine timolol with another IOP-lowering agent, indicating that additional fixed-combination alternatives would be beneficial. To meet this demand, a novel fixed combination of brinzolamide 1% and brimonidine 0.2% (BBFC) has recently been developed. In two randomized, double-masked, multinational clinical trials, BBFC had greater IOP-lowering efficacy than brinzolamide or brimonidine monotherapy after 3 months of treatment in patients with open-angle glaucoma or ocular hypertension. In both studies, the overall safety profile of BBFC was consistent with that of brinzolamide and brimonidine. Comparative studies with BBFC versus other IOP-lowering monotherapy and fixed-combination medications are not available, but the IOP reductions observed with BBFC are similar to or greater than those reported in the literature for other glaucoma treatments; thus, BBFC provides an additional fixed-combination therapeutic option for patients who require further efficacious IOP reduction and improved convenience and tolerability versus concomitant administration of two separate medications.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combination of brinzolamide and brimonidine for glaucoma and ocular hypertension: critical appraisal and patient focus

Nguyen

2014

PPA

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“…Improved adherence has been demonstrated with fixed-dose combination regimens compared with unfixed concomitant therapies in a meta-analysis of pharmacologic treatments, and also in a study of patients switching from concomitant use of latanoprost and timolol eye drops to latanoprost/timolol combination eye drops 21,22. Adherence to treatment is particularly important in chronic conditions such as glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of benzalkonium chloride-free fixed-dose combination of latanoprost and timolol in patients with open-angle glaucoma or ocular hypertension

Bhagat

Sodimalla

Paul³

et al. 2014

OPTH

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BackgroundBenzalkonium chloride (BAK) is a common preservative in topical ocular preparations; however, prolonged use may lead to deleterious effects on the ocular surface, affecting quality of life and reducing adherence to treatment and overall outcomes. This study compared the intraocular pressure (IOP)-lowering efficacy and safety of a novel once-daily, BAK-free, fixed-dose combination of latanoprost plus timolol with latanoprost or timolol administered as monotherapy or concomitantly.MethodsThis was a 6-week, randomized, open-label, parallel-group, active-controlled study in patients aged ≥18 years with open-angle glaucoma or ocular hypertension. A total of 227 patients were randomized to either a once-daily, BAK-free, fixed-dose combination of latanoprost 0.005%/timolol 0.5% ophthalmic solution or concomitant administration of once-daily latanoprost 0.005% plus twice-daily timolol 0.5% or once-daily latanoprost 0.005% monotherapy, or twice-daily timolol 0.5% monotherapy. Efficacy end points were assessed at three time points on visits at weeks 1, 2, 4, and 6 versus baseline.ResultsThe IOP-lowering efficacy of the fixed-dose combination of latanoprost/timolol was similar to that of latanoprost plus timolol administered concomitantly at all time points (mean IOP difference and 95% confidence interval within ±1.5 mmHg; P=0.4223 to P=0.9981). The fixed-dose combination of latanoprost/timolol demonstrated significantly better IOP-lowering efficacy than timolol monotherapy at all time points (P=0.001 to P<0.0001) and significantly better IOP-lowering efficacy than latanoprost monotherapy at all time points. Responder rates on at least one time point and on at least two time points with fixed-dose combination latanoprost/timolol were similar to those with concomitant latanoprost plus timolol (85.5% versus 82.1%, P=0.6360; 78.2% versus 75%, P=0.6923), but significantly better than either latanoprost or timolol monotherapy (68.5%, P=0.0355; 55.4%, P=0.0005; 57.4%, P=0.0202; and 46.4%, P=0.0006, respectively). No significant differences in ocular and nonocular treatment-emergent adverse events were found between the treatment groups.ConclusionA BAK-free, fixed-dose combination of latanoprost 0.005%/timolol 0.5% was as effective and well tolerated as concomitant latanoprost and timolol for treatment of elevated IOP in patients with open-angle glaucoma or ocular hypertension.

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“…zu führen. Einige jüngere Studien haben die mögliche Auswirkung einer Umstellung von 2 separaten Präpara-ten Latanoprost und Timolol auf die fixe Kombination aus Latanoprost/Timolol untersucht und konnten keine statistisch eindeutige Änderung beim IOD nachweisen[15,16]. Beide zitierten Studien wiesen aber im Beobachtungszeitraum eine höhere Rate an Therapiebeendigungen wegen eines insuffizienten IODs auf (8% innerhalb von 3 Monaten und 20% innerhalb von 12 Monaten).Fixe Kombinationspräparate aus Timolol und Prostaglandinanaloga zeigen einen additiv drucksenkenden Effekt im Vergleich zu den jeweiligen Monotherapien.…”

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Wirkmechanismen, klinisches Profil und Stellenwert von Betablockern in der antiglaukomatösen Therapie

Schlote¹

2013

Klin Monatsbl Augenheilkd

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Beta-blockers are among the most important groups of drugs for glaucoma therapy. The advantages of beta-blockers are a good efficacy in primary and secondary types of glaucoma, different dosages, clinical experiences over decades, easy use in combination with all other glaucoma drugs, and low costs. Timolol is the most frequently used drug in fixed glaucoma medications. In comparison with other glaucoma drugs, beta-blockers have the most severe systemic side effects and may interact with other systemic medication.

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Ocular Hypotensive Effects and Safety over 3 Months of Switching from an Unfixed Combination to Latanoprost 0.005%/Timolol Maleate 0.5% Fixed Combination

Abstract: The switch from the concomitant use of latanoprost 0.005% and timolol maleate 0.5% eye drops to latanoprost 0.005%/timolol maleate 0.5% combination eye drops improved adherence and helped maintain IOP.

Cited by 21 publications

References 16 publications

Combination of brinzolamide and brimonidine for glaucoma and ocular hypertension: critical appraisal and patient focus

Combination of brinzolamide and brimonidine for glaucoma and ocular hypertension: critical appraisal and patient focus

Efficacy and safety of benzalkonium chloride-free fixed-dose combination of latanoprost and timolol in patients with open-angle glaucoma or ocular hypertension

Wirkmechanismen, klinisches Profil und Stellenwert von Betablockern in der antiglaukomatösen Therapie

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