Latanoprost and Respiratory Function in Asthmatic Patients

Abstract

To evaluate the effects of single and multiple administrations of the ocular hypotensive drug latanoprost on respiratory function, asthma symptoms, and use of asthma medication in patients with bronchial asthma. Methods: Twenty-four stable patients with asthma (forced expiratory volume in 1 second: 70% to 90% of predicted and a minimum of 10% reversibility after inhalation of albuterol sulfate) with no previous exposure to inhaled corticosteroids participated in this randomized, double-masked crossover trial. Patients received latanoprost, 0.005%, or placebo, 1 drop per day, in each eye during two 6-day treatment periods separated by a 2-week washout period. Acute latanoprost or placebo provocation, methacholine chloride airway reactivity, and ␤ 2-stimulator reversibility tests were performed. Main Outcome Measures: Morning and evening peak expiratory flow, spirometric performance throughout treatment periods and during different provocation tests, asthma symptoms, and use of asthma medications were evaluated. Results: There were no statistically significant differences between treatments in morning and evening peak expiratory flow, scored daytime and nocturnal asthma symptoms, or daily consumption of asthma medication. During placebo provocation, there was a small increase in forced expiratory volume in 1 second that was not seen during latanoprost provocation. This small difference (−0.09 L) was statistically significant but without clinical importance. Conclusions: Resting and provoked airway function and asthma symptoms were unaffected by latanoprost treatment in patients with asthma with no previous exposure to corticosteroids. Latanoprost can be used in patients with glaucoma and concomitant bronchial asthma.

The Comparative Cardiovascular, Pulmonary, Ocular Blood Flow, and Ocular Hypotensive Effects of Topical Travoprost, Bimatoprost, Brimonidine, and Betaxolol

“…However, there is a major difference in interindividual response to PGF 2␣ . A difference in the bronchial sensitivity to PGF 2␣ between healthy subjects and asthmatic patients has been previously reported (5,6,16,19). Our findings prove that travoprost and bimatoprost may be safely used in glaucoma patients with good health.…”

“…Experiments in isolated human bronchial smooth muscle demonstrated that contractile responses to the prostanoids thromboxane A 2 , PGF 2 , and PGE 2 were predominantly mediated through the thromboxane receptor. Thromboxane A 2 and bronchoconstrictor PGD 2 and PGF 2 are generated in greater amounts in asthmatic patients than in healthy subjects (16,19,36). Although prostaglandins can be effectively removed by the lungs, they can cause bronchospasm in subjects with bronchial hyper-reactivation in several minutes and can lead to deterioration in spirometric tests (36).…”

The Comparative Cardiovascular, Pulmonary, Ocular Blood Flow, and Ocular Hypotensive Effects of Topical Travoprost, Bimatoprost, Brimonidine, and Betaxolol

“…However, there is a major difference in interindividual response to PGF 2␣ . A difference in the bronchial sensitivity to PGF 2␣ between healthy subjects and asthmatic patients has been previously reported (5,6,16,19). Our findings prove that travoprost and bimatoprost may be safely used in glaucoma patients with good health.…”

“…Experiments in isolated human bronchial smooth muscle demonstrated that contractile responses to the prostanoids thromboxane A 2 , PGF 2 , and PGE 2 were predominantly mediated through the thromboxane receptor. Thromboxane A 2 and bronchoconstrictor PGD 2 and PGF 2 are generated in greater amounts in asthmatic patients than in healthy subjects (16,19,36). Although prostaglandins can be effectively removed by the lungs, they can cause bronchospasm in subjects with bronchial hyper-reactivation in several minutes and can lead to deterioration in spirometric tests (36).…”

Meta-analysis of randomised controlled trials comparing latanoprost with timolol in the treatment of patients with open angle glaucoma or ocular hypertension

“…Therefore, caution is necessary in the use of timolol in such patients. In contrast, latanoprost does not alter heart rate and blood pressure,29 30 35 and does not affect respiratory function in asthmatic patients 55. The major adverse reaction to latanoprost is an increase in iris pigmentation.…”

A 5-year, Randomized, Open-Label Safety Study of Latanoprost and Usual Care in Patients with Open-Angle Glaucoma or Ocular Hypertension

“…Population surveys have demonstrated that as many as 40% of elderly patients have obstructive airway disease suggesting an overlap with glaucoma in a significant number of patients (24). Studies have shown that latanoprost has no effect on pulmonary function in patients with asthma (25,26). Although some systemic absorption occurs, there are no proven systemic side effects with latanoprost therapy, and none would be expected given its pharmacokinetics (27,28).…”

The Comparative Cardiovascular, Pulmonary, Ocular Blood Flow, and Ocular Hypotensive Effects of Topical Travoprost, Bimatoprost, Brimonidine, and Betaxolol

“…However, there is a major difference in interindividual response to PGF 2␣ . A difference in the bronchial sensitivity to PGF 2␣ between healthy subjects and asthmatic patients has been previously reported (5,6,16,19). Our findings prove that travoprost and bimatoprost may be safely used in glaucoma patients with good health.…”

“…Experiments in isolated human bronchial smooth muscle demonstrated that contractile responses to the prostanoids thromboxane A 2 , PGF 2 , and PGE 2 were predominantly mediated through the thromboxane receptor. Thromboxane A 2 and bronchoconstrictor PGD 2 and PGF 2 are generated in greater amounts in asthmatic patients than in healthy subjects (16,19,36). Although prostaglandins can be effectively removed by the lungs, they can cause bronchospasm in subjects with bronchial hyper-reactivation in several minutes and can lead to deterioration in spirometric tests (36).…”

Meta-analysis of randomised controlled trials comparing latanoprost with timolol in the treatment of patients with open angle glaucoma or ocular hypertension

“…Therefore, caution is necessary in the use of timolol in such patients. In contrast, latanoprost does not alter heart rate and blood pressure,29 30 35 and does not affect respiratory function in asthmatic patients 55. The major adverse reaction to latanoprost is an increase in iris pigmentation.…”

A 5-year, Randomized, Open-Label Safety Study of Latanoprost and Usual Care in Patients with Open-Angle Glaucoma or Ocular Hypertension

“…Population surveys have demonstrated that as many as 40% of elderly patients have obstructive airway disease suggesting an overlap with glaucoma in a significant number of patients (24). Studies have shown that latanoprost has no effect on pulmonary function in patients with asthma (25,26). Although some systemic absorption occurs, there are no proven systemic side effects with latanoprost therapy, and none would be expected given its pharmacokinetics (27,28).…”

The Comparative Cardiovascular, Pulmonary, Ocular Blood Flow, and Ocular Hypotensive Effects of Topical Travoprost, Bimatoprost, Brimonidine, and Betaxolol

“…However, there is a major difference in interindividual response to PGF 2␣ . A difference in the bronchial sensitivity to PGF 2␣ between healthy subjects and asthmatic patients has been previously reported (5,6,16,19). Our findings prove that travoprost and bimatoprost may be safely used in glaucoma patients with good health.…”

“…Experiments in isolated human bronchial smooth muscle demonstrated that contractile responses to the prostanoids thromboxane A 2 , PGF 2 , and PGE 2 were predominantly mediated through the thromboxane receptor. Thromboxane A 2 and bronchoconstrictor PGD 2 and PGF 2 are generated in greater amounts in asthmatic patients than in healthy subjects (16,19,36). Although prostaglandins can be effectively removed by the lungs, they can cause bronchospasm in subjects with bronchial hyper-reactivation in several minutes and can lead to deterioration in spirometric tests (36).…”

Meta-analysis of randomised controlled trials comparing latanoprost with timolol in the treatment of patients with open angle glaucoma or ocular hypertension

“…Therefore, caution is necessary in the use of timolol in such patients. In contrast, latanoprost does not alter heart rate and blood pressure,29 30 35 and does not affect respiratory function in asthmatic patients 55. The major adverse reaction to latanoprost is an increase in iris pigmentation.…”

A 5-year, Randomized, Open-Label Safety Study of Latanoprost and Usual Care in Patients with Open-Angle Glaucoma or Ocular Hypertension

“…Population surveys have demonstrated that as many as 40% of elderly patients have obstructive airway disease suggesting an overlap with glaucoma in a significant number of patients (24). Studies have shown that latanoprost has no effect on pulmonary function in patients with asthma (25,26). Although some systemic absorption occurs, there are no proven systemic side effects with latanoprost therapy, and none would be expected given its pharmacokinetics (27,28).…”