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Latanoprost in the treatment of glaucoma.

Alm A - Clin Ophthalmol (2014)

Bottom Line: Latanoprost is significantly better tolerated than either bimatoprost or travoprost.It is as effective as conventional latanoprost, has a lower incidence of hyperemia, and can be stored at room temperature.These factors should be improved further by the recent development of preservative-free latanoprost.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroscience, Ophthalmology, University Hospital, Uppsala, Sweden.

ABSTRACT
Prostaglandins are approved by the European Glaucoma Society guidelines as first-line treatment for glaucoma. This review focuses on latanoprost, an ester prodrug of prostaglandin (PG) F2α, which was the first of the currently available topical PGF2α analogs to be launched for glaucoma or ocular hypertension and which still accounts for the majority of prescriptions. It is better absorbed than the parent compound through the cornea, and peak concentration of the active drug is in the aqueous humor 1-2 hours after topical dosing (15-30 ng/mL). Metabolism occurs mainly in the liver. Latanoprost (0.005%) has been very well studied in clinical trials and meta-analyses that show it to be generally as effective as the other PG analogs (bimatoprost, travoprost, and tafluprost) and more effective than timolol, dorzolamide, and brimonidine. Latanoprost has good short- and long-term safety and tolerability profiles. In common with other prostaglandins, it lacks systemic effects, but can cause ocular adverse events such as conjunctival hyperemia, pigmentation of the iris, periocular skin or eyelashes, hypertrichosis, and ocular surface effects or irritation. Latanoprost is significantly better tolerated than either bimatoprost or travoprost. Patients treated with latanoprost have better compliance and persist with therapy longer than those that are given other drugs. An improved formulation of latanoprost without the preservative benzalkonium chloride has recently been developed. It is as effective as conventional latanoprost, has a lower incidence of hyperemia, and can be stored at room temperature. In conclusion, latanoprost has the best efficacy-tolerability ratio of the PG analogs available for glaucoma treatment, and has good compliance and persistence. These factors should be improved further by the recent development of preservative-free latanoprost.

No MeSH data available.


Related in: MedlinePlus

Ocular symptoms and signs with preserved and preservative-free glaucoma medications.Notes: Frequency of signs and functional symptoms at visit 1 and visit 2 after switch from preserved to preservative-free eye drops or decrease of the number of preserved eye drops. Republished with permission of Wichtig Editore Srl, from Eur J Ophthalmol, Ocular symptoms and signs with preserved and preservative-free glaucoma medications, Jaenen N, Baudouin C, Pouliquen P, Manni G, Figueiredo A, Zeyen T, volume 17, 2007;97 permission conveyed through Copyright Clearance Center, Inc.
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f1-opth-8-1967: Ocular symptoms and signs with preserved and preservative-free glaucoma medications.Notes: Frequency of signs and functional symptoms at visit 1 and visit 2 after switch from preserved to preservative-free eye drops or decrease of the number of preserved eye drops. Republished with permission of Wichtig Editore Srl, from Eur J Ophthalmol, Ocular symptoms and signs with preserved and preservative-free glaucoma medications, Jaenen N, Baudouin C, Pouliquen P, Manni G, Figueiredo A, Zeyen T, volume 17, 2007;97 permission conveyed through Copyright Clearance Center, Inc.

Mentions: A number of studies have demonstrated that products without preservatives are more likely to be better tolerated and, therefore, improve compliance and quality of life, and possibly even efficacy.97–99 For example, 4,107 patients with glaucoma were treated with preserved eye drops (84%), preservative-free eye drops (13%), or a combination of the two (3%).97 All symptoms were significantly (P<0.001) more prevalent with preservative eye drops than preservative-free eye drops. This included discomfort upon instillation (43% versus 17%), burning/stinging (40% versus 22%), foreign body sensation (31% versus 14%), dry eye sensation (23% versus 14%), tearing (21% versus 14%), and eyelid itching (18% versus 10%). The prevalence of signs and symptoms was dose dependent, increasing with the number of preservative eye drops. In a multinational study in 9,658 patients using preservative or preservative-free beta-blocking eye drops, a total of 74% used preservative eye drops, 12% used preservative-free eye drops, 10% used a combination, and 4% used an unknown type.97 Each symptom and all palpebral, conjunctival, and corneal signs were significantly more frequent (P<0.0001) in the preservative group than in the preservative-free group. Upon a second evaluation, there was a significant decrease (P<0.0001) in all ocular symptoms and signs in patients in whom the dose of preserved eye drops was diminished or was swapped to preservative-free drops (Figure 1).


Latanoprost in the treatment of glaucoma.

Alm A - Clin Ophthalmol (2014)

Ocular symptoms and signs with preserved and preservative-free glaucoma medications.Notes: Frequency of signs and functional symptoms at visit 1 and visit 2 after switch from preserved to preservative-free eye drops or decrease of the number of preserved eye drops. Republished with permission of Wichtig Editore Srl, from Eur J Ophthalmol, Ocular symptoms and signs with preserved and preservative-free glaucoma medications, Jaenen N, Baudouin C, Pouliquen P, Manni G, Figueiredo A, Zeyen T, volume 17, 2007;97 permission conveyed through Copyright Clearance Center, Inc.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4196887&req=5

f1-opth-8-1967: Ocular symptoms and signs with preserved and preservative-free glaucoma medications.Notes: Frequency of signs and functional symptoms at visit 1 and visit 2 after switch from preserved to preservative-free eye drops or decrease of the number of preserved eye drops. Republished with permission of Wichtig Editore Srl, from Eur J Ophthalmol, Ocular symptoms and signs with preserved and preservative-free glaucoma medications, Jaenen N, Baudouin C, Pouliquen P, Manni G, Figueiredo A, Zeyen T, volume 17, 2007;97 permission conveyed through Copyright Clearance Center, Inc.
Mentions: A number of studies have demonstrated that products without preservatives are more likely to be better tolerated and, therefore, improve compliance and quality of life, and possibly even efficacy.97–99 For example, 4,107 patients with glaucoma were treated with preserved eye drops (84%), preservative-free eye drops (13%), or a combination of the two (3%).97 All symptoms were significantly (P<0.001) more prevalent with preservative eye drops than preservative-free eye drops. This included discomfort upon instillation (43% versus 17%), burning/stinging (40% versus 22%), foreign body sensation (31% versus 14%), dry eye sensation (23% versus 14%), tearing (21% versus 14%), and eyelid itching (18% versus 10%). The prevalence of signs and symptoms was dose dependent, increasing with the number of preservative eye drops. In a multinational study in 9,658 patients using preservative or preservative-free beta-blocking eye drops, a total of 74% used preservative eye drops, 12% used preservative-free eye drops, 10% used a combination, and 4% used an unknown type.97 Each symptom and all palpebral, conjunctival, and corneal signs were significantly more frequent (P<0.0001) in the preservative group than in the preservative-free group. Upon a second evaluation, there was a significant decrease (P<0.0001) in all ocular symptoms and signs in patients in whom the dose of preserved eye drops was diminished or was swapped to preservative-free drops (Figure 1).

Bottom Line: Latanoprost is significantly better tolerated than either bimatoprost or travoprost.It is as effective as conventional latanoprost, has a lower incidence of hyperemia, and can be stored at room temperature.These factors should be improved further by the recent development of preservative-free latanoprost.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroscience, Ophthalmology, University Hospital, Uppsala, Sweden.

ABSTRACT
Prostaglandins are approved by the European Glaucoma Society guidelines as first-line treatment for glaucoma. This review focuses on latanoprost, an ester prodrug of prostaglandin (PG) F2α, which was the first of the currently available topical PGF2α analogs to be launched for glaucoma or ocular hypertension and which still accounts for the majority of prescriptions. It is better absorbed than the parent compound through the cornea, and peak concentration of the active drug is in the aqueous humor 1-2 hours after topical dosing (15-30 ng/mL). Metabolism occurs mainly in the liver. Latanoprost (0.005%) has been very well studied in clinical trials and meta-analyses that show it to be generally as effective as the other PG analogs (bimatoprost, travoprost, and tafluprost) and more effective than timolol, dorzolamide, and brimonidine. Latanoprost has good short- and long-term safety and tolerability profiles. In common with other prostaglandins, it lacks systemic effects, but can cause ocular adverse events such as conjunctival hyperemia, pigmentation of the iris, periocular skin or eyelashes, hypertrichosis, and ocular surface effects or irritation. Latanoprost is significantly better tolerated than either bimatoprost or travoprost. Patients treated with latanoprost have better compliance and persist with therapy longer than those that are given other drugs. An improved formulation of latanoprost without the preservative benzalkonium chloride has recently been developed. It is as effective as conventional latanoprost, has a lower incidence of hyperemia, and can be stored at room temperature. In conclusion, latanoprost has the best efficacy-tolerability ratio of the PG analogs available for glaucoma treatment, and has good compliance and persistence. These factors should be improved further by the recent development of preservative-free latanoprost.

No MeSH data available.


Related in: MedlinePlus