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前列腺素类似物在原发性开角型青光眼或高眼压症患者中的疗效与安全性:一项荟萃分析。

Efficacy and safety of prostaglandin analogues in primary open-angle glaucoma or ocular hypertension patients: A meta-analysis.

作者信息

Tang Wenquan, Zhang Feng, Liu Ke, Duan Xuanchu

机构信息

Department of Ophthalmology, Second Xiangya Hospital, Central South University.

Department of Ophthalmology, Hunan Province Children' Hospital.

出版信息

Medicine (Baltimore). 2019 Jul;98(30):e16597. doi: 10.1097/MD.0000000000016597.

Abstract

BACKGROUND

To evaluated and compared the efficacy and safety of 3 prostaglandin analogues (0.005% latanoprost, 0.004% travoprost, and 0.03% bimatoprost) in treatment of primary open-angle glaucoma (POAG) or ocular hypertension (OHT).

METHODS

PubMed, Embase, Cochrane library, Web of science, CNKI, Wanfang, and Vip database, published between January 1, 2000 and June 1, 2018, were systematically examined for randomized controlled trials (RCT) based on prostaglandin analogues for POAG or OHT treatment. Statistical analyses including weighted mean difference (WMD) calculation and odds ratio (OR) were performed using Review Manager Software version 5.3.

RESULT

The 17 studies were included in this analysis (N = 2433 participants) with 1∼12 months' follow-ups. The difference of intraocular pressure (IOP) reduction between latanoprost and travoprost group had not significant; there was significant difference of IOP reduction between latanoprost and bimatoprost group in the third month and sixth month; Travoprost was significantly different from bimatoprost in reducing IOP in the third month. Travoprost revealed an elevated risk of conjunctival hyperemia compared with latanoprost. An elevated risk of conjunctival hyperemia and growth of lashes compared with latanoprost. Bimatoprost shows lower ocular tolerability with higher incidence of side effects such as conjunctival hyperemia.

CONCLUSIONS

0.03% bimatoprost appears more effective following long time use (3 and 6 month post-treatment) for IOP control compared to 0.005% latanoprost, and is more effective compared to 0.004% travoprost after being used for a certain period of time (3 months post-treatment); nevertheless, 0.005% latanoprost is better tolerated in patients with POAG or OHT.

摘要

背景

评估并比较三种前列腺素类似物(0.005%拉坦前列素、0.004%曲伏前列素和0.03%比马前列素)治疗原发性开角型青光眼(POAG)或高眼压症(OHT)的疗效和安全性。

方法

系统检索2000年1月1日至2018年6月1日期间发表在PubMed、Embase、Cochrane图书馆、Web of science、中国知网、万方和维普数据库中的基于前列腺素类似物治疗POAG或OHT的随机对照试验(RCT)。使用Review Manager软件5.3版进行统计分析,包括加权平均差(WMD)计算和比值比(OR)。

结果

本分析纳入17项研究(N = 2433名参与者),随访1至12个月。拉坦前列素组和曲伏前列素组降低眼压的差异无统计学意义;拉坦前列素组和比马前列素组在第3个月和第6个月降低眼压有显著差异;曲伏前列素在第3个月降低眼压与比马前列素有显著差异。与拉坦前列素相比,曲伏前列素结膜充血风险升高。与拉坦前列素相比,结膜充血和睫毛生长风险升高。比马前列素眼部耐受性较低,结膜充血等副作用发生率较高。

结论

与0.005%拉坦前列素相比,0.03%比马前列素长期使用(治疗后3个月和6个月)控制眼压似乎更有效,与0.004%曲伏前列素相比,使用一段时间(治疗后3个月)后更有效;然而,0.005%拉坦前列素在POAG或OHT患者中耐受性更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37d9/6709278/6ccd6d712f83/medi-98-e16597-g003.jpg

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