Moosavi Reza, Ansari Ejaz
Eye Ear and Mouth Unit, Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Maidstone, UK.
Ophthalmol Ther. 2018 Dec;7(2):397-403. doi: 10.1007/s40123-018-0150-x. Epub 2018 Oct 26.
To simplify the medical treatment of glaucoma for patients on multiple drops by introducing brinzolamide/brimonidine tartrate fixed combination (BBFC) ophthalmic suspension 1%/0.2% (SIMBRINZA; Alcon Laboratories, Inc., Fort Worth, TX, USA) to the drop regimen and to establish its efficacy. To demonstrate that fixed combination (FC) therapies are associated with improvements in treatment adherence and persistence with reduced exposure to preservative-related ocular surface problems.
Retrospective study: 76 patients were identified as taking BBFC following a switch in treatment regimen. Intraocular pressure (IOP) prior to and 2-17.5 months (average 5.4 months) after the introduction of BBFC was measured. The change in the average number of bottles used per eye was recorded. The rate of adverse effects (AEs) of BBFC was recorded. A two-tailed paired sample t test was used to compare IOP prior to and after the introduction of BBFC for each eye.
Mean change in IOP after BBFC introduction BBFC: - 2.76 mmHg (p < 0.0001). BBFC intolerance: 13%. On average there was a 0.24 reduction in the number of bottles of IOP-lowering medication used per eye (p < 0.0064).
A switch to BBFC in the drop regimen is associated with a significant drop in IOP with reduced drop burden. Instead of a third IOP-lowering medication and bottle, a practitioner should consider using BBFC + prostaglandin analogue/FC drop for effective IOP control, reduced drop burden, reduced preservative load and increased likelihood of adherence. This study promotes the concept that any treatment should principally be assessed from the patients' perspective and quality of life.
通过在滴眼剂方案中引入1%/0.2%的布林佐胺/酒石酸溴莫尼定固定复方(BBFC)(西米普明;爱尔康实验室公司,美国得克萨斯州沃思堡)来简化青光眼患者多种滴眼剂的治疗,并确定其疗效。以证明固定复方(FC)疗法与治疗依从性的改善和持续性相关,同时减少与防腐剂相关的眼表问题的暴露。
回顾性研究:76例患者在治疗方案转换后被确定为使用BBFC。测量引入BBFC之前及之后2至17.5个月(平均5.4个月)的眼压(IOP)。记录每只眼睛使用的滴眼剂瓶数的变化。记录BBFC的不良反应(AE)发生率。使用双尾配对样本t检验比较每只眼睛引入BBFC之前和之后的IOP。
引入BBFC后IOP的平均变化:BBFC:-2.76 mmHg(p < 0.0001)。BBFC不耐受:13%。每只眼睛使用的降低眼压药物瓶数平均减少0.24瓶(p < 0.0064)。
滴眼剂方案转换为BBFC与IOP显著下降及滴眼剂负担减轻相关。为有效控制IOP、减轻滴眼剂负担、减少防腐剂负荷并提高依从性可能性,医生应考虑使用BBFC + 前列腺素类似物/FC滴眼剂,而非第三种降低眼压药物和滴眼剂瓶。本研究推广了这样一种观念,即任何治疗都应主要从患者的角度和生活质量进行评估。