Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
J Glaucoma. 2010 Sep;19(7):460-7. doi: 10.1097/IJG.0b013e3181c4aeac.
Latanoprost, travoprost, and bimatoprost are prostaglandin or prostamide-type ocular hypotensive medications, all of which are effective and safe for lowering intraocular pressure (IOP). Most studies with these types of drugs have included patients mainly from European or white ethnic backgrounds; however, some reports have suggested that there is a difference in response between patients of white and African racial heritage. On account of the possibility that drugs may act differently in people of different ethnic background, we decided to study the effectiveness and safety of all 3 drugs in people from various ethnic heritages. Our hypothesis was that there might be a possible ethnic-based difference in IOP-lowering effectiveness between the 3 medications.
This was a prospective randomized investigator-masked multicenter study. Patients newly diagnosed with open-angle glaucoma (primary, pseudoexfoliative, or pigmentary), or whose pressure became elevated after a washout period, were randomized to receive 1 of 3 prostaglandin/prostamide drugs. Assignment of drug was balanced by racial group and study site, and the investigator was masked to the drug used. The patients were requested to self-identify their racial group as White, African, East Indian, Asian, or Hispanic; to minimize the possibility of heterogeneity, all 4 grandparents had to be known to originate from the same group. However, for purposes of analysis, the patients were divided into 2 groups--White or Other. Patients were followed at 2, 6, 12, and 24 weeks; IOP and local side effects were assessed at each visit.
Eighty-three patients were recruited from 9 sites. The mean age of the patients was 61.5 ± 10.5 years. There were no differences in mean age or the distribution of sex between the patients whether examined by the 2 racial groups or the 3 drug groups. There was a highly statistically significant decrease in IOP from baseline to 12 weeks and from baseline to 24 weeks (F = 439.3, P<0.0001; F = 305.94, P<0.0001). There were no differences in treatment effect between the 3 drugs or between the 2 ethnic groups, (P > 0.05 for all comparisons) and there was no interaction between race and drug.
All 3 prostaglandin/amide drugs are highly effective at lowering IOP. No differences in effect between the drugs or between members of different racial groups were detected, although the study sample size was too small to be certain to detect differences, if they existed.
拉坦前列素、曲伏前列素和贝美前列素是前列腺素或前列腺酰胺类降眼压药物，均能有效安全地降低眼内压（IOP）。大多数关于这些类型药物的研究都包括了主要来自欧洲或白种人背景的患者；然而，一些报告表明，白种人和非裔美国人对药物的反应存在差异。考虑到药物在不同种族背景的人群中可能有不同的作用，我们决定研究这 3 种药物在不同种族人群中的疗效和安全性。我们的假设是，这 3 种药物在降低 IOP 方面的效果可能存在种族差异。
这是一项前瞻性、随机、研究者设盲、多中心研究。新诊断为开角型青光眼（原发性、假性剥脱性或色素性）的患者，或在洗脱期后眼压升高的患者，被随机分配接受 3 种前列腺素/前列腺酰胺类药物中的 1 种。药物的分配通过种族群体和研究地点进行平衡，研究者对使用的药物设盲。患者要求自我认定自己的种族群体为白人、非裔美国人、东印度人、亚洲人或西班牙裔；为了最大限度地减少异质性的可能性，所有 4 位祖父母都必须来自同一群体。然而，为了分析的目的，患者被分为 2 组——白人或其他。患者在第 2、6、12 和 24 周进行随访；每次就诊时评估 IOP 和局部副作用。
从 9 个地点招募了 83 名患者。患者的平均年龄为 61.5±10.5 岁。无论通过 2 个种族群体还是 3 个药物群体进行检查，患者的平均年龄或性别分布均无差异。从基线到 12 周和从基线到 24 周，IOP 均有显著统计学意义的下降（F=439.3，P<0.0001；F=305.94，P<0.0001）。3 种药物之间或 2 个种族群体之间的治疗效果无差异（所有比较的 P>0.05），种族和药物之间无相互作用。
所有 3 种前列腺素/酰胺类药物均能有效降低 IOP。虽然研究样本量太小，无法确定是否存在差异，但在检测到药物或不同种族群体之间的差异时，没有检测到药物之间或不同种族群体之间的差异。
