眼部前列腺素疗法的患者持续性：一项基于人群的回顾性研究。

Patient persistency with ocular prostaglandin therapy: a population-based, retrospective study.

作者信息

Reardon Gregory, Schwartz Gail F, Mozaffari Essy

机构信息

Informagenics, LLC, Worthington, Ohio 43085, USA.

出版信息

Clin Ther. 2003 Apr;25(4):1172-85. doi: 10.1016/s0149-2918(03)80074-7.

DOI:10.1016/s0149-2918(03)80074-7

PMID:12809964

Abstract

BACKGROUND

Open-angle glaucoma affects an estimated 33 million individuals worldwide. An intraocular pressure >21 mm Hg in individuals with no evidence of optic nerve damage is termed ocular hypertension, a risk factor for glaucoma that has been estimated to affect as many as 10% of individuals 40 years of age or older.

OBJECTIVE

The purpose of this research was to assess persistency (time on therapy) with prostaglandin analogues in the treatment of glaucoma or ocular hypertension.

METHODS

This population-based, retrospective cohort study used the Protocare Sciences managed care database, which includes prescription and medical claims data from multiple managed care organizations. Patients 20 years of age or older who initiated therapy with latanoprost, bimatoprost, or travoprost (index drugs) between April 2001 and June 2002 were included. Patients were required to be continuously enrolled in the same plan for the 180 days preceding index prescription fill. Follow-up continued through June 30, 2002. Two outcome measures were analyzed: (1) discontinuation of the index prostaglandin and (2) either discontinuation or change in the index prostaglandin regimen. Changing therapy was defined as switching to or adding another ocular hypotensive agent. Cox regression models were used to compare rate ratios of discontinuation and discontinuation/change. Patient data were censored on termination of insurance coverage or at the end of the study period.

RESULTS

Overall, 7527 patients were prescribed a prostaglandin analogue; 4356 patients met the inclusion criteria (n = 2376, 993, and 987 for latanoprost, bimatoprost, and travoprost, respectively). A total of 58% of patients were women, and 74% were 65 years of age or older. Compared with latanoprost, those treated with bimatoprost were 38% more likely to discontinue and 31% more likely to discontinue/change therapy, and patients treated with travoprost were 36% more likely to discontinue and 29% more likely to discontinue/change therapy (P < 0.001 for each comparison).

CONCLUSION

Latanoprost-treated patients demonstrated significantly (P < 0.001) greater persistency than did those treated with either bimatoprost or travoprost.

摘要

背景

全球约有3300万人患有开角型青光眼。在没有视神经损伤证据的个体中，眼压>21 mmHg被称为高眼压症，这是青光眼的一个危险因素，据估计，40岁及以上的人群中有多达10%受其影响。

目的

本研究的目的是评估前列腺素类似物治疗青光眼或高眼压症的持久性（治疗时间）。

方法

这项基于人群的回顾性队列研究使用了Protocare Sciences管理式医疗数据库，该数据库包括来自多个管理式医疗组织的处方和医疗理赔数据。纳入了2001年4月至2002年6月期间开始使用拉坦前列素、比马前列素或曲伏前列素（索引药物）进行治疗的20岁及以上患者。患者在索引处方配药前的180天内需持续参加同一保险计划。随访持续至2002年6月30日。分析了两项结局指标：（1）索引前列腺素的停药情况；（2）索引前列腺素治疗方案的停药或更改情况。更改治疗定义为换用或加用另一种降眼压药物。使用Cox回归模型比较停药率和停药/更改率。患者数据在保险覆盖终止或研究期结束时进行截尾。

结果

总体而言，7527例患者被处方了前列腺素类似物；4356例患者符合纳入标准（拉坦前列素、比马前列素和曲伏前列素分别为2376例、993例和987例）。共有58%的患者为女性，74%的患者年龄在65岁及以上。与拉坦前列素相比，使用比马前列素治疗的患者停药可能性高38%，停药/更改治疗可能性高31%；使用曲伏前列素治疗的患者停药可能性高36%，停药/更改治疗可能性高29%（每次比较P<0.001）。