Tumbocon Joseph Anthony, Wong Tina T, Sangapillai Thanendthire, Yen Yung-Chang, Park Sang-Woo, Lim Hsien Han, Ruangvaravate Ngamkae
Eye Institute, St. Luke's Medical Center, Quezon City, Philippines.
Department of Ophthalmology, St. Luke's Medical Center College of Medicine, Quezon City, Philippines.
Clin Ophthalmol. 2022 Aug 17;16:2669-2676. doi: 10.2147/OPTH.S372312. eCollection 2022.
Preserved prostaglandin analogs (PGAs) have been linked to ocular surface disease (OSD). While the benefits of preservative-low (PL) or -free (PF) Tafluprost (Santen Inc., Japan) were reported in real-world studies in Western countries, this is the first study in Asia to assess the effectiveness and safety of switching from preserved PGA to PL or PF-Tafluprost.
We conducted a meta-analysis on studies that included adults (>18 years of age) with a Corneal Fluorescein Staining Score (CFS) >1. These individuals had switched to PL or PF-tafluprost after using a preserved PGA therapy for at least 3 months for glaucoma and were identified from Santen's tafluprost study database. A total of six studies from South Korea, Philippines, Malaysia, Singapore, Thailand, Taiwan were pooled for analysis.
An intraocular pressure (IOP) reduction of 5.9% (0.91 mmHg) was seen in 265 patients. However, this result was not statistically significant (95% CI: -3.64, 1.81; Figure 1). Among 132 patients, a 47.9% reduction in the CFS (95% CI: -3.65, -1.91) was seen. Tear film break-up (n=183) significantly increased by 1.06 seconds (95% CI: 0.65, 1.47). In 88 patients, the bulbar conjunctiva score decreased by -0.46 (95% CI: -0.81, -0.10) and palpebral conjunctiva score decreased by -0.42 (95% CI: -0.67-0.17). One or more new adverse reactions were reported in 3% of the individuals after switching.
Tafluprost IOP reduction is comparable to other PGAs, with significant improvements in the ocular surface and minimal adverse reactions which were already previously reported.
保存的前列腺素类似物（PGAs）与眼表疾病（OSD）有关。虽然在西方国家的真实世界研究中报道了低防腐剂（PL）或无防腐剂（PF）他氟前列素（日本参天公司）的益处，但这是亚洲第一项评估从保存的PGA转换为PL或PF-他氟前列素的有效性和安全性的研究。
我们对纳入角膜荧光素染色评分（CFS）>1的成年人（>18岁）的研究进行了荟萃分析。这些个体在使用保存的PGA治疗青光眼至少3个月后改用PL或PF-他氟前列素，并从参天公司的他氟前列素研究数据库中识别出来。总共汇集了来自韩国、菲律宾、马来西亚、新加坡、泰国、台湾的六项研究进行分析。
265例患者的眼压（IOP）降低了5.9%（0.91 mmHg）。然而，该结果无统计学意义（95% CI：-3.64，1.81；图1）。在132例患者中，CFS降低了47.9%（95% CI：-3.65，-1.91）。泪膜破裂时间（n = 183）显著增加了1.06秒（95% CI：0.65，1.47）。在88例患者中，球结膜评分降低了-0.46（95% CI：-0.81，-0.10），睑结膜评分降低了-0.42（95% CI：-0.67，-0.17）。转换后3%的个体报告了一种或多种新的不良反应。
他氟前列素降低眼压的效果与其他PGAs相当，眼表有显著改善，且不良反应最小，这些不良反应此前已有报道。
