The risk of obstructive airways disease in a glaucoma population.

BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD), defined as obstructive airways disease (OAD), are two common chronic conditions especially in the elderly. Glaucoma is also a common disease in the elderly with a prevalence close to 5% among those older than 75 years. Most medical therapy for glaucoma is given as eye drops. It has been described that small amounts of systemically absorbed beta-blockers can produce significant respiratory adverse events in predisposed patients. METHODS: Population-based cohort study with nested case-control analysis using the UK General Practice Research Database (GPRD). We studied the prevalence of OAD in a cohort of patients 60 to 85 years old with a first ever diagnosis of glaucoma and compared it to the prevalence in an age- and sex-matched cohort sampled from the general population. We also calculated the RR and 95% CI of worsening asthma in non-severe asthma patients among the two cohorts. Incidence of OAD was studied in a cohort of glaucoma patients 60 to 85 years old and in an age- and sex-matched cohort from the general population. RESULTS: The prevalence of OAD was the same between the glaucoma cohort and the general population (OR 1.1; 95% CI 0.9-1.4). The risk of worsening asthma associated with glaucoma was OR 1.2 (95% CI 0.5-2.8). The incidence of OAD was similar in both cohorts. Current users of ophthalmic drugs presented a RR of 1.2 (95% CI 0.8-1.9) of developing asthma compared to non-users in the glaucoma population. The risk in the first month of treatment with topical beta-blockers was 2.1 (95% CI 0.7-6.7). DISCUSSION: We did not find an association between glaucoma and OAD. Use of topical glaucoma medication was not associated with a major increased risk of asthma.

Latanoprost and respiratory function in asthmatic patients: randomized, double-masked, placebo-controlled crossover evaluation.

OBJECTIVE: To evaluate the effects of single and multiple administrations of the ocular hypotensive drug latanoprost on respiratory function, asthma symptoms, and use of asthma medication in patients with bronchial asthma. METHODS: Twenty-four stable patients with asthma (forced expiratory volume in 1 second: 70% to 90% of predicted and a minimum of 10% reversibility after inhalation of albuterol sulfate) with no previous exposure to inhaled corticosteroids participated in this randomized, double-masked crossover trial. Patients received latanoprost, 0.005%, or placebo, 1 drop per day, in each eye during two 6-day treatment periods separated by a 2-week washout period. Acute latanoprost or placebo provocation, methacholine chloride airway reactivity, and 12-stimulator reversibility tests were performed. MAIN OUTCOME MEASURES: Morning and evening peak expiratory flow, spirometric performance throughout treatment periods and during different provocation tests, asthma symptoms, and use of asthma medications were evaluated. RESULTS: There were no statistically significant differences between treatments in morning and evening peak expiratory flow, scored daytime and nocturnal asthma symptoms, or daily consumption of asthma medication. During placebo provocation, there was a small increase in forced expiratory volume in 1 second that was not seen during latanoprost provocation. This small difference (-0.09 L) was statistically significant but without clinical importance. CONCLUSIONS: Resting and provoked airway function and asthma symptoms were unaffected by latanoprost treatment in patients with asthma with no previous exposure to corticosteroids. Latanoprost can be used in patients with glaucoma and concomitant bronchial asthma.