Maul Eugenio, Carrasco Félix Gil, Costa Vital Paulino, Casiraghi Javier F, Vargas Enrique, Sarmina Judith S, Mayol Renato
Pontificia Universidad Católica, Santiago, Chile.
Clin Ther. 2007 Sep;29(9):1915-23. doi: 10.1016/j.clinthera.2007.09.006.
The aim of this study was to compare the tolerability and efficacy of once-daily travoprost 0.004% versus latanoprost 0.005% for 6 weeks followed by 6 weeks of once-daily travoprost 0.004% in decreasing intraocular pressure (IOP) in patients with open-angle glaucoma (OAG) or ocular hypertension (OH).
This multicenter, randomized, doublemasked, active-controlled, parallel-group trial was conducted at 32 centers across Latin America. Patients aged > or =18 years with OAG or OH were randomly assigned to receive topical travoprost 0.004% or latanoprost 0.005% 1 drop QD (9 PM) for 6 weeks (masked phase). At 6 weeks, all patients were assigned to receive open-label travoprost 0.004% 1 drop QD (9 PM) for 6 additional weeks (open-label phase). Study visits were scheduled at weeks 1, 2, 4, 6, 8, and 12. At each study visit, IOP was measured at 5 PM (+/-1 hour; approximately 20 hours after study drug administration). IOP changes from baseline were combined (pooled) from the 1-, 2-, 4-, and 6-week data to provide a comparison between the 2 treatment groups. Ocular adverse events (AEs) were monitored using slit-lamp examination.
A total of 302 patients were enrolled (travoprost group, 155 patients; latanoprost group, 147 patients). The mean (SD) age of the travoprost group was 61.9 (10.6) years; 60.6% were female; and 47.1% were white. The mean (SD) age of the latanoprost group was 60.5 (12.4) years; 62.6% were female; and 49.0% were white. Mean IOP values were not significantly different between the travoprost and latanoprost groups at baseline (24.7 vs 24.2 mm Hg) or 6 weeks; however, the between-group difference in reductions from baseline in pooled IOP during the masked phase of the study was statistically significant (-8.3 vs -7.5 mm Hg; P = 0.009). At weeks 6 and 12, mean lOP levels were 16.1 and 16.2 mm Hg, respectively, in the travoprost group and 16.4 and 16.1 mm Hg in the group that was switched from latanoprost to travoprost (all, P = NS). The most common ocular AEs that occurred with masked travoprost, latanoprost, and open-label travoprost were hyperemia (26.9%, 12.2%, and 5.3%, respectively), discomfort (3.2%, 3.4%, and 1.1%), and pruritus (4.5%, 2.0%, and 2.1%).
In this population of patients with OAG or OH, 6-week treatment with travoprost 0.004% was associated with a significantly greater decrease from baseline in pooled IOP compared with latanoprost 0.005% 20 hours after administration. There were no significant differences between the 2 groups. Travoprost and latanoprost were well tolerated.
本研究旨在比较0.004%曲伏前列素每日一次与0.005%拉坦前列素每日一次治疗6周,随后再用0.004%曲伏前列素每日一次治疗6周,对开角型青光眼(OAG)或高眼压症(OH)患者降低眼压(IOP)的耐受性和疗效。
这项多中心、随机、双盲、活性药物对照、平行组试验在拉丁美洲的32个中心进行。年龄≥18岁的OAG或OH患者被随机分配接受局部用0.004%曲伏前列素或0.005%拉坦前列素,每晚9点1滴,共6周(双盲阶段)。在6周时,所有患者被分配接受开放标签的0.004%曲伏前列素,每晚9点1滴,再治疗6周(开放标签阶段)。研究访视安排在第1、2、4、6、8和12周。在每次研究访视时,下午5点(±1小时;给药后约20小时)测量眼压。将第1、2、4和6周的数据合并(汇总),以比较两个治疗组从基线开始的眼压变化。使用裂隙灯检查监测眼部不良事件(AE)。
共纳入302例患者(曲伏前列素组155例;拉坦前列素组147例)。曲伏前列素组的平均(标准差)年龄为61.9(10.6)岁;60.6%为女性;47.1%为白人。拉坦前列素组的平均(标准差)年龄为60.5(12.4)岁;62.6%为女性;49.0%为白人。曲伏前列素组和拉坦前列素组在基线(24.7对24.2 mmHg)或6周时的平均眼压值无显著差异;然而,在研究的双盲阶段,两组从基线开始的汇总眼压降低值之间的差异具有统计学意义(-8.3对-7.5 mmHg;P = 0.009)。在第6周和第12周,曲伏前列素组的平均眼压水平分别为16.1和16.2 mmHg,从拉坦前列素转换为曲伏前列素的组为16.4和16.1 mmHg(所有P =无显著性差异)。双盲曲伏前列素、拉坦前列素和开放标签曲伏前列素最常见的眼部AE分别是充血(分别为26.9%、12.2%和5.3%)、不适(3.2%、3.4%和1.1%)和瘙痒(4.5%、2.0%和2.1%)。
在这群OAG或OH患者中,与给药20小时后的0.005%拉坦前列素相比,0.004%曲伏前列素治疗6周与从基线开始的汇总眼压显著更大幅度降低相关。两组之间无显著差异。曲伏前列素和拉坦前列素耐受性良好。