Thelen Ulrich, Schnober Dietmar, Schölzel Sonja, Kristoffersen Michael S, Nelson Lindsay A, Stewart Jeanette A, Stewart William C
Westfalische Wilhelms-Universitat, Augenarztpraxis, Münster, Germany.
Int J Ophthalmol. 2013 Apr 18;6(2):155-9. doi: 10.3980/j.issn.2222-3959.2013.02.09. Print 2013.
To evaluate 5-year effectiveness and cost between latanoprost or timolol monotherapy in a pilot trial.
A retrospective, multi-center trial performed at 6 sites in Germany of patients who had a diagnosis of primary open-angle or pigmentary glaucoma, in at least one eye, initiated on monotherapy with latanoprost or timolol maleate. Qualified consecutive charts were reviewed in which 5-year efficacy, safety and cost data was abstracted.
Seventy-seoen latanoprost and 49 timolol patients were included, at the final visit no difference existed between the two groups in disc parameters including: rim area, rim area/disc area ratio, cup volume or vertical cup/disc ratio (P>0.05). There was no difference in intraocular pressure (IOP) between the initial latanoprost (17.4±2.6) and timolol (16.3±2.8mmHg) groups. There was less change in medicines over the follow-up period (0.1 vs 0.8) and fewer medications at the final visit (1.2 vs 1.8) with latanoprost compared to timolol. No patient treated with latanoprost discontinued therapy during follow-up, while 12% discontinued timolol mostly due to inadequate IOP control. Cost/year was less with initial timolol ($458±236) as compared to latanoprost ($552±202).
Patients begun on latanoprost or timolol and followed over 5 years may have similar clinical outcomes. However, timolol patients may require more medicines and medicine changes to control IOP for long-term, but at a lower cost.
在一项试点试验中评估拉坦前列素或噻吗洛尔单药治疗的5年疗效和成本。
在德国的6个地点进行了一项回顾性多中心试验，纳入至少一只眼睛诊断为原发性开角型或色素性青光眼且开始接受拉坦前列素或马来酸噻吗洛尔单药治疗的患者。对符合条件的连续病历进行回顾，从中提取5年疗效、安全性和成本数据。
纳入了77例使用拉坦前列素的患者和49例使用噻吗洛尔的患者，在最后一次随访时，两组在视盘参数方面无差异，包括：边缘面积、边缘面积/视盘面积比、杯状容积或垂直杯/盘比（P>0.05）。初始拉坦前列素组（17.4±2.6）和噻吗洛尔组（16.3±2.8mmHg）的眼压无差异。与噻吗洛尔相比，拉坦前列素组在随访期间药物变化较少（0.1对0.8），最后一次随访时用药较少（1.2对1.8）。接受拉坦前列素治疗的患者在随访期间无一人停药，而12%接受噻吗洛尔治疗的患者停药，主要原因是眼压控制不佳。初始使用噻吗洛尔的患者每年成本（458±236美元）低于拉坦前列素（552±202美元）。
开始使用拉坦前列素或噻吗洛尔并随访5年以上的患者可能有相似的临床结局。然而，噻吗洛尔治疗的患者可能需要更多药物和药物调整来长期控制眼压，但成本较低。
