Alezzandrini Arturo, Hubatsch Douglas, Alfaro Rene
University of Buenos Aires, Buenos Aires, Argentina,
Adv Ther. 2014 Sep;31(9):975-85. doi: 10.1007/s12325-014-0145-5. Epub 2014 Aug 20.
Fixed-combination glaucoma medications are commonly used to achieve target intraocular pressure (IOP) reduction in patients uncontrolled with monotherapy; however, ocular discomfort associated with eye drops can decrease adherence. This study assessed the efficacy and tolerability of twice-daily fixed-combination brinzolamide 1%/timolol 0.5% (BRINZ/TIM-FC) in Latin American patients transitioned from fixed-combination brimonidine 0.2%/timolol 0.5% (BRIM/TIM-FC) because of insufficient IOP control or treatment intolerance.
This 8-week, open-label, prospective study was conducted at six sites in Argentina, Chile, and Mexico. Enrolled patients were aged ≥18 years with open-angle glaucoma (including primary, exfoliative, or pigment-dispersion glaucoma) or ocular hypertension with IOP of 19-35 mmHg in ≥1 eye at baseline (on BRIM/TIM-FC). Patients self-administered BRINZ/TIM-FC to both eyes at 8 a.m. and 8 p.m. daily for 8 weeks. The primary and secondary efficacy endpoints were mean IOP change from baseline at week 8 and percentage of patients achieving target IOP (≤18 mmHg) at week 8, respectively. Exploratory endpoints included patient and investigator preference for treatment at week 8. Adverse events (AEs) were assessed as the safety endpoint.
Fifty patients (mean ± SD age, 66.7 ± 11.5 years) received BRINZ/TIM-FC, and 49 were included in the intent-to-treat population. Mean ± SD IOP was significantly reduced from baseline after 8 weeks of treatment with BRINZ/TIM-FC (-3.6 ± 3.0 mmHg; P < 0.0001, Wilcoxon signed-rank test; 17.1% reduction). Overall, 55.3% of patients achieved IOP ≤18 mmHg at week 8. Significantly more patients (89.4%) and investigators (95.7%) preferred BRINZ/TIM-FC to BRIM/TIM-FC (both P < 0.0001, exact binomial test). Of the 13 AEs observed, 8 were related to BRINZ/TIM-FC; the most common treatment-related AEs were eye irritation (n = 4) and abnormal sensation in the eye (n = 2).
BRINZ/TIM-FC provides an effective and well-tolerated treatment option for patients transitioned from BRIM/TIM-FC.
固定复方青光眼药物常用于降低单药治疗无法控制眼压(IOP)的患者的目标眼压;然而,滴眼液引起的眼部不适会降低依从性。本研究评估了每日两次的固定复方布林佐胺1%/噻吗洛尔0.5%(BRINZ/TIM-FC)对因眼压控制不佳或治疗不耐受而从固定复方溴莫尼定0.2%/噻吗洛尔0.5%(BRIM/TIM-FC)转换过来的拉丁美洲患者的疗效和耐受性。
这项为期8周的开放标签前瞻性研究在阿根廷、智利和墨西哥的六个地点进行。入选患者年龄≥18岁,患有开角型青光眼(包括原发性、剥脱性或色素性青光眼)或眼压升高,基线时(使用BRIM/TIM-FC)至少一只眼睛的眼压为19-35 mmHg。患者每天上午8点和晚上8点自行将BRINZ/TIM-FC滴入双眼,持续8周。主要和次要疗效终点分别是第8周时眼压相对于基线的平均变化以及第8周时达到目标眼压(≤18 mmHg)的患者百分比。探索性终点包括第8周时患者和研究者对治疗的偏好。不良事件(AE)被评估为安全性终点。
50名患者(平均±标准差年龄,66.7±11.5岁)接受了BRINZ/TIM-FC治疗,49名患者被纳入意向性分析人群。使用BRINZ/TIM-FC治疗8周后,眼压平均±标准差较基线显著降低(-3.6±3.0 mmHg;P<0.0001,Wilcoxon符号秩检验;降低17.1%)。总体而言,55.3%的患者在第8周时眼压≤18 mmHg。明显更多的患者(89.4%)和研究者(95.7%)更喜欢BRINZ/TIM-FC而非BRIM/TIM-FC(两者P<0.0001,精确二项式检验)。在观察到的13例不良事件中,8例与BRINZ/TIM-FC相关;最常见的与治疗相关的不良事件是眼部刺激(n = 4)和眼部异常感觉(n = 2)。
对于从BRIM/TIM-FC转换过来的患者,BRINZ/TIM-FC提供了一种有效且耐受性良好的治疗选择。