Switching from concomitant therapy to tafluprost/timolol fixed combination.

PURPOSE: To evaluate the efficacy and safety of tafluprost/timolol fixed combination (TTFC). STUDY DESIGN: A prospective clinical study. METHODS: Twenty-eight patients (28 eyes) with primary open-angle glaucoma, who had used tafluprost and timolol gel for at least 3 months with good adherence, were enrolled. Concomitant administration of tafluprost and timolol was switched to TTFC without a washout period. The intraocular pressure (IOP), blood pressure, pulse rate, and ocular signs were compared between before switching (baseline), and 4 and 8 weeks after switching. A questionnaire survey was also performed 4 weeks after switching to investigate ocular comfort and patient preferences. RESULTS: The IOP showed no significant change after switching to TTFC (14.8 ± 2.8, 14.6 ± 3.4, and 14.8 ± 3.7 mmHg at baseline, Week 4, and Week 8, respectively). The pulse rate and systolic blood pressure showed no changes, but diastolic blood pressure was significantly lower at Week 8. At baseline, fluorescein staining revealed corneal abnormalities in 3 patients, which resolved by Week 8 in 1 patient. Hyperemia was noted in 2 patients at baseline, and this also resolved by Week 8 in 1 patient. Three patients discontinued study treatment for the following reasons (1 patient each): blurred vision; ocular irritation, eyelid erythema, and asthenopia; and loss to follow-up from Week 8. The questionnaire survey revealed no significant differences between the 2 treatments, although more patients preferred TTFC. CONCLUSION: Among 28 patients enrolled, only 2 patients discontinued the study treatment due to adverse reactions. In patients whose adherence was considered relatively good to concomitant therapy, switching to TTFC achieved similar IOP control with good safety and a high level of patient acceptance.

Efficacy and safety of adding ripasudil to existing treatment regimens for reducing intraocular pressure.

PURPOSE: Ripasudil accelerates aqueous humour drainage along the trabecular meshwork-Schlemm's canal route and has been approved for clinical use in Japan. We retrospectively investigated the efficacy and safety of adding ripasudil to existing treatment regimens to reduce intraocular pressure (IOP) in patients with glaucoma. METHODS: A total of 119 eyes from 119 subjects (61 men, 58 women) with primary open-angle glaucoma or ocular hypertension who had ripasudil added to their treatment regimens between December 2014 and June 2015 were included. An average of 3.8 ± 1.0 anti-glaucoma medications was in use before adding ripasudil. Subjects were divided into four groups based on the number of medications included in the original treatment regimen: ≤2, 3, 4, or ≥5 medications. The IOP was compared before and after 1 and 3 months of treatment with ripasudil for all subjects and between groups. Patients for whom ripasudil use was discontinued within 3 months were also examined. RESULTS: The IOP was significantly lower in all patients after 1 month (17.5 ± 4.5 mmHg) and 3 months (16.8 ± 4.2 mmHg) of treatment than it was before (19.8 ± 5.3 mmHg, p < 0.0001). All groups were equivalent in the rate and magnitude of IOP change. Ripasudil administration was discontinued in five patients (4.2%) prior to the end of the study: three were lost to follow-up and two underwent glaucoma surgery. CONCLUSION: Adding ripasudil to existing glaucoma treatment regimens is effective and safe in reducing IOP, regardless of the number of medications in use.

Efficacy and safety of switching to latanoprost 0.005%-timolol maleate 0.5% fixed-combination eyedrops from an unfixed combination for 36 months.

PURPOSE: We prospectively investigated the intraocular pressure (IOP)-reducing effect, the visual field-maintenance effect, and the adverse reactions caused by administration of latanoprost/timolol maleate fixed-combination eyedrops for 3 years. SUBJECTS AND METHODS: The subjects were 162 patients (162 eyes) with glaucoma or ocular hypotension who were using latanoprost and timolol maleate eyedrops concomitantly. The latanoprost and timolol maleate eyedrop regimen was discontinued without any washout period and subsequently changed to a latanoprost-timolol maleate fixed-combination eyedrop regimen. IOP values before the change and at 6, 12, 18, 24, 30, and 36 months after the change were measured and compared. The Humphrey visual field test was conducted before the change and at 12, 24, and 36 months after the change, and mean-deviation values were compared. Adverse reactions were assessed at every checkup. RESULTS: The IOPs before the change and at 6-36 months after the change were 15.2±3.3 mmHg and 14.3-15.2 mmHg, respectively, and a significant decrease was observed at 36 months after the change (P<0.01). Mean-deviation values before the change and at 12-36 months after the change were -9.11±6.94 dB and -10.08 to -9.22 dB, respectively, and these values were not significantly different (P=0.2148). Within the 36-month period, the eyedrops were discontinued because of insufficient IOP decrease in 33 cases (20.4%) and adverse reactions in eleven cases (6.8%). CONCLUSION: IOP and the visual field were maintained for 3 years when a latanoprost and timolol maleate eyedrop regimen was changed to a latanoprost-timolol maleate fixed-combination eyedrop regimen. However, administration of the latanoprost-timolol maleate fixed-combination eyedrops was discontinued in approximately 27% of cases because of insufficient IOP decrease and adverse reactions.

Assessment of ocular hypotensive effect and safety 12 months after changing from an unfixed combination to a latanoprost 0.005% + timolol maleate 0.5% fixed combination.

BACKGROUND: Latanoprost 0.005% + timolol maleate 0.5% combined eyedrops were recently made available in Japan. We prospectively investigated the intraocular pressure (IOP)-lowering effect, visual preservation effect, and adverse reactions of a one-year administration of this fixed combination. METHODS: The subjects included 162 eyes from 162 patients diagnosed with either primary open-angle glaucoma or ocular hypertension and using an unfixed combination of latanoprost 0.005% and timolol maleate 0.5%. The unfixed combination was discontinued and replaced with the latanoprost 0.005% + timolol maleate 0.5% fixed combination with no washout period. IOP was measured before (baseline) and 3, 6, 9, and 12 months after the change. The mean deviation value of Humphrey field analysis was compared. Adverse reactions were examined at every follow-up. RESULTS: No significant differences were found between mean IOP values obtained at baseline (mean ± standard deviation, 15.2 ± 3.3 mmHg) 3 months (15.1 ± 3.2 mmHg), 6 months (15.3 ± 3.1 mmHg), 9 months (15.3 ± 3.1 mmHg), and 12 months (15.1 ± 3.2 mmHg) after the change from the unfixed to the fixed combination of eyedrops (P = 0.212). In addition, no significant differences were observed between mean deviation values obtained at baseline (-9.11 ± 6.94 dB) and 12 months (-10.08 ± 7.24 dB) after the change (P = 0.114). Thirty-one patients discontinued the fixed combination within 12 months of replacement, due to an insufficient IOP decrease (20 patients, 12.3%) and adverse reactions (11 patients, 6.8%). CONCLUSION: Following replacement of two eyedrop medications (latanoprost 0.005% and timolol maleate 0.5%) by one fixed combination (latanoprost 0.005% + timolol maleate 0.5%), IOP and visual field were preserved. However, 20% of the patients discontinued the new treatment because of an insufficient IOP decrease and complaints of adverse reactions.

Ocular hypotensive effects and safety over 3 months of switching from an unfixed combination to latanoprost 0.005%/timolol maleate 0.5% fixed combination.

PURPOSE: Latanoprost 0.005%/timolol maleate 0.5% combination eye drops are now available in Japan. The aim of the present study was to investigate the prospective intraocular pressure (IOP) reduction effects and adherence with the combination eye drops in Japanese patients. METHODS: The subjects were 162 patients (162 eyes) with glaucoma or ocular hypertension concomitantly using latanoprost 0.005% and timolol maleate 0.5% eye drops. Concomitant use of the 2 eye drops was stopped, and patients were switched to the latanoprost 0.005%/timolol maleate 0.5% combination eye drops without any washout period. IOP was measured before the switch, and at 1 and 3 months after the switch, and then compared. A questionnaire survey on adherence was also conducted 1 month after the switch. RESULTS: IOP was the same before and after the switch: 15.2±3.3 mmHg before the switch, 14.9±3.0 mmHg 1 month after the switch, and 15.1±3.2 mmHg 3 months after the switch. According to the questionnaire survey, the frequency of forgetting to administer eye drops decreased with the switch, but 45.1% of the patients experienced irritation. About 82.1% replied that they preferred the latanoprost 0.005%/timolol maleate 0.5% combination eye drops. By the third month after the switch, 13 patients (8.0%) had discontinued the eye drops due to side effects or insufficient IOP reduction. CONCLUSION: 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.