Abstract:Travoprost is a prostaglandin analogue widely used for reducing intraocular pressure (IOP) in patients affected with glaucoma and ocular hypertension. It exerts its ocular hypotensive effect through the prostaglandin FP receptors, located in the ciliary muscle and the trabecular meshwork. Several studies have shown that topical administration of travoprost induces a mean IOP reduction ranging from 25% to 32%, and sustained throughout the 24-hour cycle. When compared with timolol, travoprost is more effective a… Show more
“…TTFC has been reported to have a neutral pH, which allows for the high permeability of the β component into the eye 17. Quaranta et al discussed the IOP-lowering effect of TTFC when switched from travoprost monotherapy in their review report 18,19. From their reports there is a possibility of greater IOP-lowering effect of TTFC when switched from travoprost than other FC when switched from each PGA.…”
BackgroundWe have shown a decrease in mean intraocular pressure (IOP) by switching to travoprost/timolol fixed combination (TTFC) in subjects receiving prostaglandin analogue (PGA) monotherapy and requiring additional medication in a previous report. For analyzing factors affecting IOP reduction, baseline IOP and preceding PGA were selected as statistically and clinically significant factors. In this report, we examine IOP-lowering effect and adverse drug reactions by preceding PGA.MethodsPatients with primary open angle glaucoma or ocular hypertension who received monotherapy with one of four PGAs (travoprost, latanoprost, tafluprost, or bimatoprost) for at least 3 months at 26 institutions and were determined to require additional medication by their primary physician were included. IOP reduction and adverse events were examined at 4, 8, and 12 weeks for each of four PGAs after switching to TTFC.ResultsIn total, 157 patients who could be followed up for at least 4 weeks after switching to TTFC were included in the efficacy analysis. Multiple regression analysis was performed, and baseline IOP and PGA were found to be significant factors to IOP reduction. IOP reduction at week 12, adjusted with the regression model, was −3.5, −1.8, and −1.4 mmHg in the tafluprost, latanoprost, and travoprost groups, whereas it was −0.5 mmHg in the bimatoprost group. Along with differences in baseline IOP between groups, an IOP-lowering effect of >1 mmHg was noted in the tafluprost, latanoprost, and travoprost groups after the switch. IOP was maintained at 13.8–14.8 mmHg throughout the follow-up period. No serious adverse events or noteworthy issues were observed in any group after the switch.ConclusionClinically significant IOP-reducing effects of TTFC were observed in the latanoprost, travoprost, and tafluprost groups when switching from each PGA monotherapy, while there were some differences in effects between groups, with minimal safety concerns.
“…TTFC has been reported to have a neutral pH, which allows for the high permeability of the β component into the eye 17. Quaranta et al discussed the IOP-lowering effect of TTFC when switched from travoprost monotherapy in their review report 18,19. From their reports there is a possibility of greater IOP-lowering effect of TTFC when switched from travoprost than other FC when switched from each PGA.…”
BackgroundWe have shown a decrease in mean intraocular pressure (IOP) by switching to travoprost/timolol fixed combination (TTFC) in subjects receiving prostaglandin analogue (PGA) monotherapy and requiring additional medication in a previous report. For analyzing factors affecting IOP reduction, baseline IOP and preceding PGA were selected as statistically and clinically significant factors. In this report, we examine IOP-lowering effect and adverse drug reactions by preceding PGA.MethodsPatients with primary open angle glaucoma or ocular hypertension who received monotherapy with one of four PGAs (travoprost, latanoprost, tafluprost, or bimatoprost) for at least 3 months at 26 institutions and were determined to require additional medication by their primary physician were included. IOP reduction and adverse events were examined at 4, 8, and 12 weeks for each of four PGAs after switching to TTFC.ResultsIn total, 157 patients who could be followed up for at least 4 weeks after switching to TTFC were included in the efficacy analysis. Multiple regression analysis was performed, and baseline IOP and PGA were found to be significant factors to IOP reduction. IOP reduction at week 12, adjusted with the regression model, was −3.5, −1.8, and −1.4 mmHg in the tafluprost, latanoprost, and travoprost groups, whereas it was −0.5 mmHg in the bimatoprost group. Along with differences in baseline IOP between groups, an IOP-lowering effect of >1 mmHg was noted in the tafluprost, latanoprost, and travoprost groups after the switch. IOP was maintained at 13.8–14.8 mmHg throughout the follow-up period. No serious adverse events or noteworthy issues were observed in any group after the switch.ConclusionClinically significant IOP-reducing effects of TTFC were observed in the latanoprost, travoprost, and tafluprost groups when switching from each PGA monotherapy, while there were some differences in effects between groups, with minimal safety concerns.
“…PGAs have demonstrated better IOP-lowering ability than β -blockers with fewer systemic adverse effects [86–88]. They act by increasing uveoscleral and TM outflow and reduction in IOP starts 2–4 hours after first administration.…”
Section: Contemporary Pharmacological Management Of Glaucomamentioning
confidence: 99%
“…Several studies have shown that topical administration of travoprost leads to a mean IOP reduction from 25% to 32%, which is sustained throughout the 24-hour cycle [88, 89]. In a prospective, open-label, single-arm study conducted in Italy ( N = 36 previously untreated POAG patients), travoprost monotherapy at a dose of 0.004% administered once in the evening (8:00 pm) induced uniform 24-hour IOP reduction.…”
Section: Contemporary Pharmacological Management Of Glaucomamentioning
confidence: 99%
“…Although mean nocturnal IOP reduction with travoprost was somewhat lower than mean daytime IOP reduction, there was no significant difference between nighttime and daytime efficacy [89]. A preservative-free formulation of travoprost 0.004% is available to reduce tolerability-related problems in subjects affected with ocular surface disease [88]. …”
Section: Contemporary Pharmacological Management Of Glaucomamentioning
Glaucoma is a medical term describing a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and retinal nerve fibre layer and resulting in changes in the optic nerve head. Glaucoma is a leading cause of irreversible vision loss worldwide. With the aging population it is expected that the prevalence of glaucoma will continue to increase. Despite recent advances in imaging and visual field testing techniques that allow establishment of earlier diagnosis and treatment initiation, significant numbers of glaucoma patients are undiagnosed and present late in the course of their disease. This can lead to irreversible vision loss, reduced quality of life, and a higher socioeconomic burden. Selection of therapeutic approaches for glaucoma should be based on careful ocular examination, patient medical history, presence of comorbidities, and awareness of concomitant systemic therapies. Therapy should also be individualized to patients' needs and preferences. Recent developments in this therapeutic field require revisiting treatment algorithms and integration of traditional and novel approaches in order to ensure optimal visual outcomes. This article provides an overview of recent developments and practice trends in the medical management of glaucoma in Canada. A discussion of the surgical management is beyond the scope of this paper.
“…Using the impression citology, Sezgin Akcay et al 2014 found that polyquaternium (PP)-preserved travoprost is safer and better tolerated than benzalkonium chloride (BAK)-preserved travoprost. That's the reason why the compliance of patients increases (Quaranta 2015, Peace 2015. It may be an advantageous prostaglandin analog option for patients affected by open-angle glaucoma (OAG) or ocular hypertension (OHT) who are intolerant to BAK-preserved latanoprost or bimatoprost (Konstas et al 2017).…”
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