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First-line glaucoma monotherapy medication patterns in Finland during 1995-2019 based on a population-based study
Petri K M Purola1,2, Seppo V P Koskinen3, Hannu M T Uusitalo1,2,4
1Faculty of Medicine and Health Technology, Department of Ophthalmology, Tampere University, Tampere, Finland.
Plos One
|January 30, 2025
Summary
Glaucoma medication patterns show a shift towards prostaglandin analogues, but early discontinuation and non-persistence remain challenges in first-line therapy.
Area of Science:
- Ophthalmology
- Pharmacology
- Public Health
Background:
- Long-term patterns of first-line glaucoma medication are not well established.
- Understanding these patterns is crucial for healthcare systems to plan glaucoma care.
- Longitudinal, population-based studies are needed to inform glaucoma management strategies.
Purpose of the Study:
- To evaluate patterns in first-line glaucoma monotherapy in Finland.
- The study period spans 25 years, from 1995 to 2019.
- Utilized nationwide survey and register data for comprehensive analysis.
Main Methods:
- Population-based cohort study with 25 years of follow-up.
- Included a random sample (n=9288) from the FinHealth 2017 survey.
- Linked register data identified glaucoma patients and their medication use.
Main Results:
- A shift from beta-blockers to prostaglandin analogues as first-line therapy was observed.
- Persistence rates were 64% at 1 year, 37% at 3 years, and 21% at 5 years.
- Non-persistence affected 38% of patients; timolol fixed-combinations were common second-line treatments.
Conclusions:
- A significant shift in first-line glaucoma drug classes occurred over 25 years.
- Despite this shift, early discontinuation and non-persistence remain significant clinical challenges.
- Longer initial therapies are becoming more common, but early decline in continuation persists.
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