Persistency with latanoprost or timolol in primary open-angle glaucoma suspects

Area of Science:

• Ophthalmology
• Pharmacology
• Health Services Research

Background:

• Primary open-angle glaucoma suspects require consistent pharmacotherapy for management.
• Medication persistency is crucial for effective long-term treatment of ocular conditions.
• Latanoprost and timolol are common first-line treatments for glaucoma suspects.

Purpose of the Study:

• To compare the pharmacotherapy persistency between latanoprost and timolol in patients diagnosed as glaucoma suspects.
• To evaluate discontinuation and discontinuation/change rates for these two ocular hypotensive agents.

Main Methods:

• Retrospective cohort study utilizing a large managed care database (approx. 3 million members).
• Inclusion criteria: patients aged 20+ years, new users of latanoprost or timolol monotherapy, continuous enrollment, no prior glaucoma surgery, and glaucoma suspect diagnoses.
• Outcome measures: drug discontinuation and discontinuation or change in therapy, analyzed using Cox regression models.

Main Results:

• 1,474 patients met inclusion criteria; 583 received latanoprost and 891 received timolol.
• Timolol users were 39% more likely to discontinue therapy and 27% more likely to discontinue or change therapy compared to latanoprost users (P <.001).
• At 12 months, 39% of latanoprost patients and 25% of timolol patients maintained therapy without discontinuation.

Conclusions:

• Latanoprost treatment demonstrated significantly greater persistency in glaucoma suspects compared to timolol.
• The underlying reasons for this difference in medication adherence warrant further investigation.
• The clinical implications of this persistency difference on intraocular pressure control and disease progression require additional research.