Short-term Efficacy and Safety of a Latanoprost/Carteolol Fixed Combination Switched From Concomitant Therapy to in Patients With Primary Open-angle Glaucoma or Ocular Hypertension

Abstract

Purpose: We prospectively investigated the efficacy and safety of switching from concomitant latanoprost and carteolol hydrochloride (CH) to a latanoprost/carteolol fixed combination (LCFC) in patients with primary open-angle glaucoma or ocular hypertension. Patients and Methods: A total of 43 patients (43 eyes) who were using latanoprost (once daily in the evening) and CH (once daily in the morning) concomitantly were switched to LCFC (once daily in the morning) with no washout interval. The primary efficacy endpoint was change in intraocular pressure (IOP) between baseline (before switching) and 1 and 3 months after switching. Systemic blood pressure and pulse rate, corneal epithelial defects, and tear film break-up time (TBUT) were also compared before and 1 and 3 months after switching. A questionnaire was administered 1 month after switching to investigate ocular comfort and treatment preferences. Adverse reactions and dropouts were recorded. Results: There was no significant difference in IOP after switching to LCFC (15.0±2.6, 15.1±2.4, and 15.0±2.4 mm Hg at baseline and at 1 and 3 months, respectively). There was a significant decrease in corneal epithelial defects and significant increase in TBUT, without significant changes in systemic blood pressure or pulse rate. Three patients (7.3%) preferred concomitant latanoprost and CH; 33 (80.5%) preferred the LCFC. One patient each (9.3%) discontinued treatment because of foreign body sensation, blepharitis, increased IOP, or loss to follow-up. Conclusions: Switching from concomitant latanoprost and CH to LCFC led to similar IOP control with good safety and patient acceptance, at least in the short term.

Topical Medication Therapy for Glaucoma and Ocular Hypertension

“…LC-FC has the same IOP lowering effect as the non-fixed combination of carteolol and latanoprost (LC-nFC) and LT-FC, and exerts a greater effect than carteolol and latanoprost monotherapy ( Yamamoto et al, 2016 ; Inoue et al, 2018 ; Inoue et al, 2020b ). In the study 1 of a two phase 3 clinical trial, 220 patients were treated with LC-FC (n = 113) or latanoprost (n = 116) for 8 weeks, while in the study 2, 175 patients were treated with LC-FC (n = 76), carteolol (n = 76), or LC-nFC (n = 37) for 8 weeks.…”

“…The adjusted mean IOP reduction in the study 1 was 2.9 and 1.6 mmHg in the LC-FC and latanoprost-treated patients, in the study two was 3.5, 3.5, and 1.6 mmHg in LC-FC, LC-nFC, and carteolol-treated patients ( Yamamoto et al, 2016 ). When patients with POAG or OHT were treated with LC-nFC and then switched to LC-FC, they showed an IOP of 15.0 ± 2.6, 15.1 ± 2.4, and 15.0 ± 2.4 mmHg at baseline, month 1 and 3, respectively ( Inoue et al, 2018 ). When patients with POAG, NTG, or OHT were treated with LT-FC and then switched to LC-FC, they showed a not significantly changed mean IOP after 1 month (15.9 ± 3.1 mmHg) and 3 months (16.3 ± 3.8 mmHg) compared to the baseline IOP with LT-FC (16.1 ± 3.1 mmHg) ( Inoue et al, 2020b ).…”

“…The AEs related to LC-FC observed in clinical trials are mild ( Yamamoto et al, 2016 ), and common ocular AEs include hyperemia, irritation, itching, pain, and blurred vision ( Inoue et al, 2018 ). The incidence of ocular AEs decreases when the therapy switches from LC-nFC to LC-FC ( Inoue et al, 2018 ), so LC-FC may provide better tolerance. The pulse rate and blood pressure do not significantly change in patients treated with LC-FC ( Yamamoto et al, 2016 ; Inoue et al, 2018 ).…”

“…The incidence of ocular AEs decreases when the therapy switches from LC-nFC to LC-FC ( Inoue et al, 2018 ), so LC-FC may provide better tolerance. The pulse rate and blood pressure do not significantly change in patients treated with LC-FC ( Yamamoto et al, 2016 ; Inoue et al, 2018 ).…”

<p>Short-Term Efficacy and Safety of Switching from a Latanoprost/Timolol Fixed Combination to a Latanoprost/Carteolol Fixed Combination</p>

“…We have previously investigated the effects of a switch from latanoprost and carteolol therapy to an LCFC. 1 In that study, there was no significant difference in intraocular pressure (IOP) after switching and adherence was improved because of a decrease in the number of daily doses required; furthermore, many patients preferred treatment with an LCFC. In a Phase III clinical trial conducted in Japan, IOP was lowered effectively and safely in patients who were switched from latanoprost or carteolol monotherapy to LCFC.…”