Department of Ophthalmology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.
Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
BMC Ophthalmol. 2024 Jul 11;24(1):281. doi: 10.1186/s12886-024-03550-2.
Glaucoma treatment often involves multi-drug regimens, which can lead to poor adherence and side effects. Fixed-dose combinations aim to improve adherence and reduce side effects compared to traditional therapies. This study aimed to compare the prevalence and clinical characteristics of ocular allergy in glaucoma patients using brinzolamide 1.0%/brimonidine 0.2% fixed combination (BBFC), with and without concurrent β-blocker.
Of these, 176 patients used a β-blocker concurrently, whereas 96 patients did not. Allergy prevalence, allergy type, and allergy occurrence time were compared between the concurrent and non-concurrent β-blocker-usage groups. Ocular allergies were classified and evaluated using Kaplan-Meier survival analysis.
Allergy prevalence was 10.23% and 15.63% (p = 0.193), whereas allergy occurrence time was 15.92 ± 13.80 months and 6.26 ± 6.20 months (p = 0.04) in the concurrent and non-concurrent β-blocker-usage groups, respectively. Kaplan-Meier survival analysis indicated that half of the allergies in the concurrent β-blocker-usage group occurred within 12.5 months, with the BBFC discontinuation rate gradually increasing up to 36 months. Contrarily, half of the allergies in the non-concurrent β-blocker-usage group occurred within 3.3 months, with a rapid increase in BBFC discontinuation rate the first 6 months. Intergroup differences in allergy types were significant (p = 0.015). Among all patients with allergy, the average allergy occurrence time of blepharoconjunctivitis, papillary conjunctivitis, and follicular conjunctivitis was 12.52, 9.53, and 13.23 months, respectively. Follicular conjunctivitis tended to occur later than papillary conjunctivitis (p = 0.042). In the concurrent β-blocker-usage group, follicular conjunctivitis was the most prevalent allergy type (61.1%), whereas papillary conjunctivitis was the most common (66.7%) in in the non-concurrent β-blocker-usage group.
Concurrent use of β-blocker with BBFC decreases allergy prevalence, delays allergy onset, and predominantly results in follicular conjunctivitis, thereby facilitating longer treatment duration. Understanding these characteristics of allergy in BBFC users is useful to manage patients and improve treatment adherence. This study provides insights into the role of β-blockers in modulating ocular allergy in BBFC-treated glaucoma patients, highlighting implications for clinical practice and patient education.
青光眼的治疗通常涉及多药物治疗方案，这可能导致患者的依从性差和出现副作用。与传统疗法相比，固定剂量组合旨在提高依从性并减少副作用。本研究旨在比较使用布林佐胺 1.0%/溴莫尼定 0.2%固定组合（BBFC）治疗的青光眼患者中眼部过敏的患病率和临床特征，这些患者中有和没有同时使用β受体阻滞剂。
其中，176 名患者同时使用了β受体阻滞剂，而 96 名患者未使用。比较同时使用和不使用β受体阻滞剂的患者群体中的过敏患病率、过敏类型和过敏发生时间。使用 Kaplan-Meier 生存分析对眼部过敏进行分类和评估。
在同时使用β受体阻滞剂的患者群体中，过敏患病率为 10.23%和 15.63%（p=0.193），而过敏发生时间为 15.92±13.80 个月和 6.26±6.20 个月（p=0.04）。Kaplan-Meier 生存分析表明，在同时使用β受体阻滞剂的患者群体中，有一半的过敏反应发生在 12.5 个月内，BBFC 的停药率逐渐增加至 36 个月。相反，在未同时使用β受体阻滞剂的患者群体中，有一半的过敏反应发生在 3.3 个月内，在最初的 6 个月内 BBFC 的停药率迅速增加。过敏类型的组间差异具有统计学意义（p=0.015）。在所有过敏患者中，睑结膜炎、乳头性结膜炎和滤泡性结膜炎的平均过敏发生时间分别为 12.52、9.53 和 13.23 个月。滤泡性结膜炎的发生时间晚于乳头性结膜炎（p=0.042）。在同时使用β受体阻滞剂的患者群体中，滤泡性结膜炎是最常见的过敏类型（61.1%），而在未同时使用β受体阻滞剂的患者群体中，乳头性结膜炎是最常见的过敏类型（66.7%）。
BBFC 与β受体阻滞剂同时使用可降低过敏的患病率，延迟过敏的发生，并主要导致滤泡性结膜炎，从而延长治疗时间。了解 BBFC 使用者过敏的这些特征有助于管理患者并提高治疗依从性。本研究深入了解了β受体阻滞剂在调节 BBFC 治疗的青光眼患者眼部过敏中的作用，突出了其对临床实践和患者教育的影响。
