Use of Latanoprostene Bunod as Adjunctive Glaucoma Therapy in Refractory Glaucoma

Abstract

A bstract Aim To investigate the long-term efficacy of adjunctive use of latanoprostene bunod (LBN), a new nitric oxide donating prostaglandin medication, in refractory cases of glaucoma at a tertiary care center. Materials and methods A review for patients who received add-on LBN was conducted from 1 st January 2018 to 31 st August 2020. A total of 33 patients (53 eyes) met the inclusion criteria of being on ≥3 topical medications, having an intraocular pressure measurement prior to starting LBN, and having adequate follow-up. Baseline demographics, prior treatments, adverse effects, and intraocular pressures measured at baseline, 3, 6, and 12 months were recorded. Results Mean baseline intraocular pressure (IOP) [mm Hg ± standard deviation (SD)] was 19.9 ± 6.0. At 3 months, 49 eyes had a mean IOP of 17.3 ± 5.5 ( p < 0.01) with an absolute reduction of 2.6 ± 6.6 and a percent reduction of 9 ± 28%. At 6 months, 35 eyes had a mean IOP of 17.2 ± 4.7 ( p < 0.01) with an absolute reduction of 3.6 ± 7.4 and a percent reduction of 11 ± 30%. At 12 months, 28 eyes had a mean IOP of 16 ± 4.5 ( p < 0.01) with an absolute reduction of 5.8 ± 7.4 and a percent reduction of 19 ± 38%. Over the course of the study, 18 eyes were lost to follow-up. Three eyes had a laser trabeculoplasty, and four eyes required incisional surgery. No eyes discontinued the medication due to adverse effects. Conclusion Adjunctive use of LBN in refractory glaucoma showed clinically and statistically significant IOP reductions at 3, 6, and 12-month time points. IOP reduction in patients was stable throughout the course of the study, with the largest decreases seen at the 12-month interval. Clinical significance LBN was well tolerated by patients and may be useful as an additive agent in providing long-term intraocular pressure reduction for patients with severe glaucoma on maximal therapy. How to cite this article Zhou B, Bekerman VP, Khouri AS. Use of Latanoprostene Bunod as Adjunctive Glaucoma Therapy in Refractory Glaucoma. J Curr Glaucoma Pract 2022;16(3):166-169.

Latanoprostene Bunod 0.024% in Patients with Open-Angle Glaucoma Switched from Prior Pharmacotherapy: A Retrospective Chart Review

“…[17][18][19] In fact, while the responder analysis in the prior study of late-stage patients showed substantial proportions of patients achieved IOP lowering of ≥2, ≥3, and ≥4 mm Hg (60%, 46%, and 34%, respectively), 13 the responder analysis in the current study of patients with mild-to-moderate OAG/OHT showed that even higher proportions of patients achieved these levels of IOP lowering (≥80%, ≥75%, and ≥65%, respectively, at both post-index visits) in the overall dataset as well as in the subgroups who were switched from a prior PGA. Also of interest, in a retrospective analysis examining adjunctive use of LBN in patients with refractory glaucoma who were using 3 or more topical agents, addition of LBN produced an IOP reduction of 9% at 3 months, 14 whereas in a retrospective chart review of LBN in treatment-naïve patients (mean baseline IOP, 21.7 mm Hg in study eyes), LBN produced mean IOP decreases of ~31% from baseline to each follow-up visit. 19 Collectively, these realworld analyses demonstrate that LBN effectively lowers IOP across a wide range of OAG disease severities.…”

“…Since receiving marketing approval, retrospective chart reviews of LBN have demonstrated additional IOP-lowering when LBN either replaced prior therapy in predominantly late-stage glaucoma patients or was used as an adjunctive therapy in patients predominantly on multiple medications. [13][14][15] The current study was specifically conducted to investigate the realworld efficacy (IOP-lowering) and safety of LBN in a representative sample of patients with mild-to-moderate OAG/ OHT who were on 1-2 topical IOP-lowering therapies and switched 1 or both of these existing treatments to LBN.…”