Kashiwagi K, Tsukahara S
University of Yamanashi Faculty of Medicine, Tamaho Yamanashi, Japan.
Br J Ophthalmol. 2003 Mar;87(3):297-301. doi: 10.1136/bjo.87.3.297.
To investigate the effects of a non-steroidal anti-inflammatory drug (NSAID) ophthalmic solution on latanoprost induced intraocular pressure (IOP) reduction using normal volunteers.
This study was conducted as a prospective and observer masked clinical trial. 13 normal volunteers were enrolled. After measurement of basal IOP and ophthalmic examination, latanoprost ophthalmic solution was initially administered to both eyes once daily. Four weeks later, an NSAID ophthalmic solution, sodium 2-amino-3-(4-bromobenzoyl) phenylacetate sesquihydrate (refer to bromfenac sodium hydrate), was co-administered to one randomly selected eye (NSAID group) twice daily for 2 weeks. The other eye was employed as a control (non-NSAID group). After withdrawal of the NSAID ophthalmic solution, latanoprost ophthalmic solution was continuously administered for another 2 weeks and was then withdrawn. After a 4 week washout, only bromfenac sodium hydrate ophthalmic solution was administered to the eyes of the NSAID group for 2 weeks. During the study period, ophthalmic examination, including IOP measurement was performed in an observer masked fashion.
Before initiation of bromfenac sodium hydrate, baseline IOPs of the non-NSAID group and the NSAID group were 15.73 (SD 1.97) mm Hg and 15.86 (2.06) mm Hg, respectively (p=0.88). Although latanoprost ophthalmic solution significantly reduced IOP in both groups, co-administration of bromfenac sodium hydrate significantly inhibited latanoprost induced IOP reduction compared with the non-NSAID group. The IOPs of the non-NSAID and NSAID groups were 10.18 (1.17) mm Hg and 11.63 (1.35) mm Hg with a 2 week co-administration, respectively (p <0.01). Withdrawal of bromfenac sodium hydrate ophthalmic solution diminished the difference between the two groups. Re-administration of bromfenac sodium ophthalmic solution only did not affect IOP.
These results indicate that NSAID ophthalmic solution may interfere with IOP reduction by latanoprost ophthalmic solution in normal volunteers and that we should take this into account when treating patients with glaucoma using latanoprost ophthalmic solution.
使用正常志愿者研究一种非甾体抗炎药（NSAID）滴眼液对拉坦前列素降低眼压（IOP）的影响。
本研究作为一项前瞻性、观察者设盲的临床试验进行。招募了13名正常志愿者。在测量基础眼压和进行眼科检查后，最初每天给双眼各使用一次拉坦前列素滴眼液。四周后，将一种NSAID滴眼液，即2-氨基-3-(4-溴苯甲酰基)苯乙酸倍半水合物钠（参考溴芬酸钠水合物），随机选取一只眼睛每天使用两次，共2周（NSAID组）。另一只眼睛作为对照（非NSAID组）。停用NSAID滴眼液后，继续给拉坦前列素滴眼液使用2周，然后停用。经过4周的洗脱期后，仅给NSAID组的眼睛使用溴芬酸钠水合物滴眼液2周。在研究期间，以观察者设盲的方式进行眼科检查，包括眼压测量。
在开始使用溴芬酸钠水合物之前，非NSAID组和NSAID组的基线眼压分别为15.73（标准差1.97）mmHg和15.86（2.06）mmHg（p = 0.88）。尽管拉坦前列素滴眼液在两组中均显著降低了眼压，但与非NSAID组相比，联合使用溴芬酸钠水合物显著抑制了拉坦前列素引起的眼压降低。联合使用2周时，非NSAID组和NSAID组的眼压分别为10.18（1.17）mmHg和11.63（1.35）mmHg（p < 0.01）。停用溴芬酸钠水合物滴眼液减小了两组之间的差异。仅重新使用溴芬酸钠滴眼液对眼压没有影响。
这些结果表明，NSAID滴眼液可能会干扰拉坦前列素滴眼液在正常志愿者中降低眼压的作用，并且在使用拉坦前列素滴眼液治疗青光眼患者时我们应考虑到这一点。
