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Patient persistence with first-line antiglaucomatous monotherapy
Alfonso Arias1, Konrad Schargel, Fernando Ussa
1Ophthalmology Department, Fundación Hospital Alcorcón, Madrid, Spain.
Clinical Ophthalmology (Auckland, N.Z.)
|May 14, 2010
Summary
Latanoprost demonstrates superior patient persistence in glaucoma treatment compared to bimatoprost, travoprost, and timolol. This sustained use may improve intraocular pressure control and reduce healthcare costs.
Area of Science:
- Ophthalmology
- Pharmacology
- Health Economics
Background:
- Glaucoma management requires long-term adherence to topical medications.
- Prostaglandins and beta-blockers are common first-line monotherapies for glaucoma.
Purpose of the Study:
- To compare the persistence of glaucoma patients treated with prostaglandin analogs (latanoprost, bimatoprost, travoprost) versus timolol monotherapy.
- To identify factors influencing treatment adherence in glaucoma patients.
Main Methods:
- Retrospective observational study with 24-month follow-up of 191 glaucoma patients.
- Data extracted from medical charts, including treatment discontinuation dates.
- Kaplan-Meier survival analysis and Cox regression to assess drug persistence and influencing variables.
Main Results:
- Latanoprost showed significantly higher persistence (81.6%) at 24 months compared to bimatoprost (22.9%), travoprost (65.4%), and timolol (60.5%).
- Treatment discontinuation risk was six times higher with bimatoprost versus latanoprost.
- Patient age and the specific antiglaucoma agent were significant predictors of persistence.
Conclusions:
- Latanoprost is associated with greater patient persistence in routine glaucoma care compared to other monotherapies.
- Higher persistence with latanoprost may lead to improved intraocular pressure control and reduced economic burden.
- Lack of efficacy and adverse events were primary reasons for discontinuation, particularly with bimatoprost.
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