Xu Kai Man, Cho Ryan, Chan Toby Yiu Bong
Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada.
Division of Ophthalmology, Department of Surgery, McMaster University, Waterloo Regional Campus, Kitchener-Waterloo, Ontario, Canada.
Clin Ophthalmol. 2022 Jul 29;16:2385-2390. doi: 10.2147/OPTH.S368214. eCollection 2022.
Studies comparing the two different formulations of bimatoprost, 0.03% and 0.01%, have shown similar efficacy, but a better adverse effect profile for bimatoprost 0.01% in patients with primary open-angle glaucoma (POAG) and ocular hypertension (OHT). This study assesses the efficacy and tolerability of switching from bimatoprost 0.01% to 0.03% in a patient population with broader spectrum of diagnoses in a real-world clinical setting.
Single-centre retrospective observational switch study.
Selected patients were on initial topical therapy with bimatoprost 0.01% prior to switching to bimatoprost 0.03%. Intraocular pressure (IOP) was collected from their pre-switch visit, 6- and 12-week after switch. Paired two-sample -test was performed to compare IOP at different time points versus baseline. Worsening of hyperemia and other adverse events after the switch were identified. Subgroup analysis was performed for POAG and OHT, secondary open-angle glaucoma (SOAG, including pseudoexfoliative and pigmentary glaucoma), normal tension glaucoma (NTG), and angle closure glaucoma (ACG).
The study population consisted of 248 eyes (143 patients). There was a significant mean IOP reduction of 1.0 ± 3.7 mmHg (p < 0.001, n = 248) from baseline to week-6 and 1.6 ± 4.0 mmHg (p < 0.001, n = 142) from baseline to week-12 after switch. The IOP reduction was statistically significant in patients with POAG and OHT (6-week: 1.0 ± 3.8 mmHg, n = 76; 12-week: 1.5 ± 4.1 mmHg, n = 49), ACG (6-week: 1.5 ± 4.1 mmHg, n = 72; 12-week: 2.3 ± 4.5 mmHg, n = 46), and NTG (6-week: 0.83 ± 2.5 mmHg, n = 42; 12-week: 1.12 ± 2.1 mmHg, n = 25). Patients with SOAG did not show statistically significant reduction in IOP at 6- or 12-week after switch. Forty-two (29%) of 143 patients experienced adverse events, with the most common being hyperemia (16%).
Significant reduction in IOP could be seen after switching from bimatoprost 0.01% to bimatoprost 0.03% in various types of glaucoma except SOAG. Intolerance after switch may be experienced, though not in the majority of cases.
比较两种不同浓度比马前列素（0.03%和0.01%）的研究表明，它们在原发性开角型青光眼（POAG）和高眼压症（OHT）患者中疗效相似，但0.01%比马前列素的不良反应谱更佳。本研究在真实临床环境中，对诊断范围更广的患者群体评估从0.01%比马前列素转换为0.03%比马前列素后的疗效和耐受性。
单中心回顾性观察性转换研究。
选定患者在从0.01%比马前列素转换为0.03%比马前列素之前，最初接受0.01%比马前列素局部治疗。在转换前就诊时、转换后6周和12周收集眼压（IOP）。进行配对双样本t检验，以比较不同时间点的眼压与基线眼压。确定转换后充血加重及其他不良事件。对POAG和OHT、继发性开角型青光眼（SOAG，包括剥脱性青光眼和色素性青光眼）、正常眼压性青光眼（NTG）和闭角型青光眼（ACG）进行亚组分析。
研究人群包括248只眼（143例患者）。转换后从基线到第6周，平均眼压显著降低1.0±3.7 mmHg（p<0.001，n = 248），从基线到第12周降低1.6±4.0 mmHg（p<0.001，n = 142）。POAG和OHT患者（6周：1.0±3.8 mmHg，n = 76；12周：1.5±4.1 mmHg，n = 49）、ACG患者（6周：1.5±4.1 mmHg，n = 72；12周：2.3±4.5 mmHg，n = 46）和NTG患者（6周：0.83±2.5 mmHg，n = 42；12周：1.12±2.1 mmHg，n = 25）的眼压降低具有统计学意义。SOAG患者在转换后6周或12周眼压未显示出统计学上的显著降低。143例患者中有42例（29%）发生不良事件，最常见的是充血（16%）。
除SOAG外，从0.01%比马前列素转换为0.03%比马前列素后，各类青光眼患者的眼压均有显著降低。转换后可能会出现不耐受情况，不过大多数病例中未出现。
