Efficacy, safety, and improved tolerability of travoprost BAK-free ophthalmic solution compared with prior prostaglandin therapy

Abstract

Purpose: To evaluate the effi cacy, safety and tolerability of changing to travoprost BAK-free from prior prostaglandin therapy in patients with primary open-angle glaucoma or ocular hypertension. Design: Prospective, multi-center, historical control study. Methods: Patients treated with latanoprost or bimatoprost who needed alternative therapy due to tolerability issues were enrolled. Patients were surveyed using the Ocular Surface Disease Index (OSDI) to evaluate OSD symptoms prior to changing to travoprost BAK-free dosed once every evening. Patients were re-evaluated 3 months later. Results: In 691 patients, travoprost BAK-free demonstrated improved mean OSDI scores compared to either latanoprost or bimatoprost (p Ͻ 0.0001). Patients having any baseline OSD symptoms (n = 235) demonstrated signifi cant improvement after switching to travoprost BAK-free (p Ͻ 0.0001). In 70.2% of these patients, symptoms were reduced in severity by at least 1 level. After changing medications to travoprost BAK-free, mean intraocular pressure (IOP) was signifi cantly decreased (p Ͻ 0.0001). Overall, 72.4% preferred travoprost BAK-free (p < 0.0001, travoprost BAK-free vs prior therapy). Travoprost BAK-free demonstrated less conjunctival hyperemia than either prior therapy (p Ͻ 0.0001). Conclusions: Patients previously treated with a BAK-preserved prostaglandin analog who are changed to travoprost BAK-free have clinically and statistically signifi cant improvement in their OSD symptoms, decreased hyperemia, and equal or better IOP control.

Tear cytokine profile of glaucoma patients treated with preservative-free or preserved latanoprost

“…Different preservativefree PGAs are currently available that are no less effective in reducing IOP than their preserved counterparts [26e28]. Furthermore, switching studies revealed that changing from preserved to preservative-free medications significantly improved signs and symptoms related to OSDs [29,30].…”

Ocular surface disease in patients with glaucoma or ocular hypertension treated with either BAK-preserved latanoprost or BAK-free travoprost

“…In a previous large multicenter clinical trial of patients with glaucoma who had been previously treated with either latanoprost 0.005% or bimatoprost 0.03%, and who needed alternative therapy due to tolerability issues, a switch to BAK-free travoprost 0.004% resulted in improvement in OSD symptoms that were both clinically and statistically significant, and maintained equal or better control of IOP. 14 However, that study was not conducted in a parallel, randomized, masked fashion. The objective of this current multicenter, double-masked, randomized, controlled study was to quantify changes in symptoms of OSD after randomizing patients with open-angle glaucoma or ocular hypertension who were previously treated with latanoprost 0.005% preserved by 0.02% BAK (Xalatan ® ophthalmic solution; Pfizer Inc., NY) either to remain on BAK-preserved latanoprost 0.005% or to change to BAK-free travoprost 0.004% (Travatan Z ® ophthalmic solution; Alcon Laboratories, Inc., Fort Worth, TX).…”

<p>Impact of Ocular Surface Disease Treatment in Patients with Glaucoma</p>

“…Surface inflammation is a hallmark of OSD and topical treatment toxicity. 33,34 Bulbar redness had a significant improvement after OSD treatment in both eyes. Although several antiglaucoma medications lead to conjunctival hyperemia, 29,35,36 the significant reduction in bulbar redness occurred despite the maintenance of all glaucoma eyedrops previously in use.…”

“…38,39 Henry et al have observed statistically significant IOP reduction in glaucoma patients who switched from BAK-preserved prostaglandin to preservativefree travoprost. 34 In a similar study, but with a very small sample (n=4), Batra et al suggested that severe OSD could exacerbate glaucoma due to inflammation and scarring of the trabecular meshwork and demonstrated that an intensive OSD treatment including preservative-free lubricants, preservativefree antiglaucoma medication and oral doxycycline improved IOP control. 22 Their study was a retrospective review of the files of four patients with uncontrolled primary open angle glaucoma.…”