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1.
Drugs Today (Barc) ; 55(9): 563-574, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31584573

RESUMO

The fixed-dose combination (FDC) of netarsudil 0.02%/ latanoprost 0.005% was approved by the United States Food and Drug Administration (FDA) on March 12, 2019, for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma (OAG) and ocular hypertension (OHT). Netarsudil is a Rho kinase (ROCK) inhibitor and latanoprost is a prostaglandin analogue (PGA). Once-daily administration of this FDC reduces IOP by enhancing aqueous outflow through both the trabecular pathways (ROCK inhibition) and uveoscleral pathways (PGA). Two phase III clinical trials, MERCURY-1 and MERCURY-2, confirmed significantly greater efficacy of the FDC than the individual components, with IOP reductions of 30% or greater observed in 59-65% of subjects treated with FDC compared with 29-37% of subjects treated with latanoprost alone and 21-29% of subjects treated with netarsudil alone. The FDC was well tolerated with mostly mild ocular side effects and limited systemic side effects. This paper will review the work leading to FDA approval and the clinical indications for the use of this combination.


Assuntos
Benzoatos/uso terapêutico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Latanoprosta/uso terapêutico , Hipertensão Ocular/tratamento farmacológico , beta-Alanina/análogos & derivados , Anti-Hipertensivos/uso terapêutico , Aprovação de Drogas , Quimioterapia Combinada , Humanos , Estados Unidos , United States Food and Drug Administration , beta-Alanina/uso terapêutico
2.
Medicina (Kaunas) ; 55(7)2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31336766

RESUMO

Background and Objectives: Topically administered antiglaucoma medications, especially those containing benzalkonium chloride (BAC), may cause local adverse effects and compromise ocular surface. The aim of the study was to assess the effect of topical prostaglandin F2α analogs (PGAs): preservative-free latanoprost, BAC-preserved latanoprost, preservative-free tafluprost, and BAC-preserved bimatoprost, on selected oxidative stress parameters in the tear film. Materials and Methods: The patients were divided into five groups: group C (n = 25) control group-subjects who did not use topical antiglaucoma medications, group L (n = 22)-patients using topical preservative-free latanoprost, group L+BAC (n = 25)-patients using topical BAC-preserved latanoprost, group T (n = 19)-patients using topical preservative-free tafluprost, and group B+BAC (n = 17)-patients using topical BAC-preserved bimatoprost. The oxidative stress markers in the tear film samples were evaluated: total protein (TP) concentration, advanced oxidation protein products (AOPP) content, total sulfhydryl (-SH) groups content, the activity of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), as well as Total Oxidant Status (TOS), Total Antioxidant Response (TAR), and Oxidative Stress Index (OSI). Results: The TP concentrations in the groups L, L+BAC, and B+BAC were statistically significantly higher in comparison with group C. The SOD and CAT activities in the groups L+BAC and B+BAC were statistically significantly higher when compared to group C. As compared to group C, AOPP and TOS were statistically significantly higher in all the study groups. OSI was found to be statistically significantly higher in the groups L+BAC, T, and B+BAC in comparison with group C. Conclusion: Use of topical PGAs by the patients with ocular hypertension or primary open-angle glaucoma is associated with increased oxidative stress in the tear film which is additionally exacerbated by the presence of BAC in the formulation.


Assuntos
Dinoprosta/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Lágrimas/química , Administração Tópica , Compostos de Benzalcônio/farmacocinética , Compostos de Benzalcônio/farmacologia , Compostos de Benzalcônio/uso terapêutico , Estudos Transversais , Dinoprosta/farmacocinética , Dinoprosta/uso terapêutico , Glaucoma/tratamento farmacológico , Humanos , Latanoprosta/farmacocinética , Latanoprosta/farmacologia , Latanoprosta/uso terapêutico , Estresse Oxidativo/fisiologia , Polônia , Prostaglandinas F/farmacocinética , Prostaglandinas F/farmacologia , Prostaglandinas F/uso terapêutico , Lágrimas/efeitos dos fármacos
3.
Medicine (Baltimore) ; 98(30): e16597, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348303

RESUMO

BACKGROUND: To evaluated and compared the efficacy and safety of 3 prostaglandin analogues (0.005% latanoprost, 0.004% travoprost, and 0.03% bimatoprost) in treatment of primary open-angle glaucoma (POAG) or ocular hypertension (OHT). METHODS: PubMed, Embase, Cochrane library, Web of science, CNKI, Wanfang, and Vip database, published between January 1, 2000 and June 1, 2018, were systematically examined for randomized controlled trials (RCT) based on prostaglandin analogues for POAG or OHT treatment. Statistical analyses including weighted mean difference (WMD) calculation and odds ratio (OR) were performed using Review Manager Software version 5.3. RESULT: The 17 studies were included in this analysis (N = 2433 participants) with 1∼12 months' follow-ups. The difference of intraocular pressure (IOP) reduction between latanoprost and travoprost group had not significant; there was significant difference of IOP reduction between latanoprost and bimatoprost group in the third month and sixth month; Travoprost was significantly different from bimatoprost in reducing IOP in the third month. Travoprost revealed an elevated risk of conjunctival hyperemia compared with latanoprost. An elevated risk of conjunctival hyperemia and growth of lashes compared with latanoprost. Bimatoprost shows lower ocular tolerability with higher incidence of side effects such as conjunctival hyperemia. CONCLUSIONS: 0.03% bimatoprost appears more effective following long time use (3 and 6 month post-treatment) for IOP control compared to 0.005% latanoprost, and is more effective compared to 0.004% travoprost after being used for a certain period of time (3 months post-treatment); nevertheless, 0.005% latanoprost is better tolerated in patients with POAG or OHT.


Assuntos
Glaucoma de Ângulo Aberto/tratamento farmacológico , Hipertensão Ocular/tratamento farmacológico , Prostaglandinas Sintéticas/uso terapêutico , Bimatoprost/uso terapêutico , Humanos , Pressão Intraocular/efeitos dos fármacos , Latanoprosta/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Travoprost/uso terapêutico
4.
PLoS One ; 14(1): e0211631, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30703139

RESUMO

PURPOSE: Prostaglandin analogues (PG) reduce intra-ocular pressure by enhancing uveoscleral flow at the ciliary body, which controls accommodation via the ciliary muscle. We investigated the effect of PG on accommodation and presbyopia progression in glaucoma patients. METHODS: We conducted a clinic-based, retrospective, cross-sectional study. Inclusion criteria were bilateral phakic patients aged 40-69 years with best corrected visual acuity better than 20/30. Exclusion criteria were any disease affecting vision other than glaucoma and history of ocular surgery. Subjects with no prescription or vision-affecting disease served as controls (n = 260). The glaucoma patients were prescribed eye drops containing 0.005% latanoprost for more than six months (n = 23). We measured the binocular near add power at a distance of 30 cm in both groups and compared the results using Kaplan-Meier analysis. RESULTS: The mean age (± SD) of the control subjects was 51.5 ± 5.2 years and 39% were male. Similarly, the glaucoma patients had a mean age of 51.0 ± 7.2 years and 39% were male. There were no significant differences in age, gender, intra-ocular pressure, spherical equivalent, astigmatism, or anisometropia between groups. Survival analysis indicated that the glaucoma patients in this study reached the endpoint (near add power of +3.00 D) significantly earlier than control patients (P = 0.0001; generalized Wilcoxon test). CONCLUSIONS: Exacerbation of presbyopia progression in glaucoma patients is a potential side effect of latanoprost eyedrops.


Assuntos
Anti-Hipertensivos/uso terapêutico , Latanoprosta/uso terapêutico , Presbiopia/tratamento farmacológico , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Presbiopia/patologia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
5.
Vet Ophthalmol ; 22(4): 448-461, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30716184

RESUMO

OBJECTIVE: To compare the effects of topical 0.005% latanoprost (L) vs combined 0.005% latanoprost and 1% atropine (LA) on control of postoperative ocular hypertension (POH), development of posterior synechiae formation, pupil size, and blindness after phacoemulsification surgery in dogs. ANIMAL STUDIED: Dogs with postoperative ocular hypertension were included in the study: L-group, latanoprost (eight dogs, 14 eyes) and LA-group, latanoprost and atropine (nine dogs, 15 eyes). PROCEDURES: Complete ophthalmic examinations including tonometry were performed at 1, 7, and 21 days following phacoemulsification. RESULTS: No significant differences were found between the measured intraocular pressure (IOP) at days 1 and 7 postphacoemulsification surgery in the L-group and the LA-group (P = 0.26 [14.12 ± 1.76 mmHg vs 16.96 ± 1.68 mmHg] and P = 0.71 [15.45 ± 1.43 mmHg vs 16.20 ± 1.36 mmHg], respectively). No significant differences were found between pupil sizes at day 7 for the two groups (P = 0.25 [13.83% vs 24.77%]). No significant differences were found between odds of posterior synechiae formation at day 21 (P = 0.92) with a probability ± SE for L-group vs LA-group at 0.27 ± 0.14 vs 0.25 ± 0.13. No significant differences were found in odds of postoperative blindness between groups (P = 0.58) with a probability ± SE of 0.21 ± 0.11 vs 0.13 ± 0.09, respectively for L and LA. CONCLUSIONS: Combined topical latanoprost and atropine in dogs maintains normal postoperative IOPs but does not seem to cause increased mydriasis compared to latanoprost alone.


Assuntos
Atropina/uso terapêutico , Doenças do Cão/tratamento farmacológico , Latanoprosta/uso terapêutico , Hipertensão Ocular/veterinária , Soluções Oftálmicas/uso terapêutico , Facoemulsificação/veterinária , Complicações Pós-Operatórias/veterinária , Animais , Atropina/administração & dosagem , Cegueira/etiologia , Cegueira/prevenção & controle , Cegueira/veterinária , Catarata/veterinária , Cães , Quimioterapia Combinada/veterinária , Feminino , Latanoprosta/administração & dosagem , Implante de Lente Intraocular/veterinária , Masculino , Hipertensão Ocular/tratamento farmacológico , Hipertensão Ocular/etiologia , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/tratamento farmacológico , Estudos Retrospectivos
6.
Eur J Ophthalmol ; 29(6): 645-653, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30301370

RESUMO

PURPOSE: Preservatives in glaucoma medications have been associated with ocular toxicity. We compared ocular signs and symptoms in patients with open-angle glaucoma or ocular hypertension treated in monotherapy with preserved or preservative-free prostaglandin analogues. METHODS: Observational cross-sectional clinical study in real life. 82 patients treated for at least 6 months with prostaglandin analogue were assessed for intraocular pressure, ocular symptoms and ocular signs including conjunctival hyperaemia, tear break-up time and tear meniscus height measured using objective and non-invasive methods (OCULUS Keratograph 5M). Patients presenting with symptoms of ocular toxicity with preserved prostaglandin analogues were switched to preservative-free latanoprost, and a second assessment was processed 6 months after. RESULTS: At inclusion, 30 (36.6%) patients were treated with preservative-free latanoprost, 25 (30.5%) with preserved latanoprost, 16 (19.5%) with preserved travoprost and 11 (13.4%) with preserved bimatoprost. Patients treated with preservative-free latanoprost reported significantly less ocular symptoms upon instillation (mainly burning) and between instillations than patients treated with preserved prostaglandin analogues. The mean conjunctival hyperaemia (limbal + bulbar) was significantly lower with preservative-free latanoprost (2.08 ± 0.55) compared to preserved latanoprost (2.50 ± 0.7, p = 0.0085), preserved travoprost (2.67 ± 0.82, p = 0.0083) and preserved bimatoprost (2.68 ± 0.67, p = 0.0041). There were no relevant between-group differences in mean tear meniscus height and break-up time. Ocular symptoms and conjunctival hyperaemia improved when preserved prostaglandin analogues were switched to preservative-free latanoprost for 6 months while intraocular pressure reduction was maintained. CONCLUSION: Overall, this study suggests a better subjective and objective ocular tolerance when patients were treated with preservative-free latanoprost than with other preserved prostaglandin analogues monotherapy. Switching to preservative-free latanoprost maintained intraocular pressure at the same level as preservative prostaglandin analogue, but improved ocular surface tolerance.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Conservantes Farmacêuticos/uso terapêutico , Prostaglandinas Sintéticas/uso terapêutico , Administração Oftálmica , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/efeitos adversos , Bimatoprost/efeitos adversos , Bimatoprost/uso terapêutico , Doenças da Túnica Conjuntiva/induzido quimicamente , Estudos Transversais , Feminino , Humanos , Hiperemia/induzido quimicamente , Pressão Intraocular/efeitos dos fármacos , Latanoprosta/efeitos adversos , Latanoprosta/uso terapêutico , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/tratamento farmacológico , Soluções Oftálmicas , Conservantes Farmacêuticos/efeitos adversos , Prostaglandinas Sintéticas/efeitos adversos , Tonometria Ocular , Travoprost/efeitos adversos , Travoprost/uso terapêutico
7.
Eur J Ophthalmol ; 29(2): 210-215, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29998767

RESUMO

PURPOSE:: To assess tolerability and efficacy following a switch from benzalkonium chloride-latanoprost to preservative-free latanoprost in patients with glaucoma or ocular hypertension. METHODS:: A total of 140 patients with glaucoma or ocular hypertension controlled with benzalkonium chloride-latanoprost for at least 3 months were switched to treatment with preservative-free latanoprost. Assessments were made on days 15, 45, and 90 (D15, D45, and D90) and included best-corrected visual acuity, intraocular pressure, slit lamp examination, fluorescein staining, tear film break-up time, patient symptom evaluation, and subjective estimation of tolerability. RESULTS:: Mean best-corrected visual acuity remained unchanged during the study. Mean intraocular pressure compared with baseline (D0) remained stable throughout the study (D0, 15.9 mmHg (standard deviation = 2.6); D90, 15.3 mmHg (standard deviation = 2.4); p < 0.006). Tear film break-up time improved or remained unchanged relative to baseline in 92% of patients at D45 and in 93% at D90. Moderate-to-severe conjunctival hyperemia was seen in 56.8% of patients at D0, but this figure decreased to 13.7%, 2.2%, and 1.6% at D15, D45, and D90, respectively. Subjective assessment of tolerability (0-10 scale) indicated improvement with change of therapy (mean score: 5.3 (standard deviation = 2.2) at D0 versus 1.9 (standard deviation = 1.7) at D90; p < 0.0001). CONCLUSION:: Preservative-free latanoprost has at least the same intraocular pressure-lowering efficacy as benzalkonium chloride-latanoprost, with a better tolerability profile. This may translate into greater control of treatment and improved quality of life.


Assuntos
Tolerância a Medicamentos , Glaucoma de Ângulo Aberto/tratamento farmacológico , Pressão Intraocular/efeitos dos fármacos , Latanoprosta/uso terapêutico , Hipertensão Ocular/tratamento farmacológico , Anti-Hipertensivos/uso terapêutico , Feminino , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/fisiopatologia , Conservantes Farmacêuticos , Resultado do Tratamento
8.
Ocul Immunol Inflamm ; 27(2): 181-188, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29028372

RESUMO

There is debate concerning whether the use of Latanoprost in early postoperative period of cataract surgery and in glaucoma patients with uveitis as it may aggravate the inflammation and results in macular edema (ME), because of blood-ocular barrier disruption. However, there is no solid evidence for disruption of blood-ocular barrier with Latanoprost and aggravation of uveitis or ME formation. Similar to pseudophakic ME, the imaging ME in cases claimed to be secondary to Latanoprost is greater than clinical ME, happens mostly in complicated surgeries, and the vast majority resolve within weeks to months with using a non-steroidal anti-inflammatory drug. The current literature suggests that Latanoprost can be used in patients with uveitis and early after cataract surgery with or without concomitant topical non-steroidal anti-inflammatory drugs that are currently used by many ophthalmologists as a preventive measure for ME even in non-glaucoma uncomplicated cataract surgeries.


Assuntos
Latanoprosta/uso terapêutico , Edema Macular/tratamento farmacológico , Uveíte/tratamento farmacológico , Anti-Hipertensivos/uso terapêutico , Humanos , Inflamação/tratamento farmacológico , Edema Macular/etiologia , Uveíte/complicações
9.
Medicine (Baltimore) ; 97(51): e13833, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30572551

RESUMO

BACKGROUND: Latanoprost is quiet new formulation that is approved for the treatment of primary open angle glaucoma (POAG). However, no updated systematic review has addressed its efficacy for POAG. This systematic review of randomized controlled trials (RCTs) aims to assess its efficacy and safety for the treatment of patients with POAG. METHODS: This study will search the databases of CENTRAL, EMBASE, MEDILINE, CINAHL, AMED and Chinese databases without language restrictions from their inception to the present. It will only include RCTs of latanoprost for POAG. The quality of the included RCTs will be evaluated by the tool of Cochrane risk of bias. The primary outcomes will be measured by the mean IOP reduction from baseline to the endpoint. The secondary outcomes will be assessed by the mean IOP, adjusted mean IOP reduction at each time point, quality of life, and adverse events. The RevMan V.5.3 software will be used to compute the data synthesis carefully if the meta-analysis is allowed. The summary results of the included RCTs will be conducted by using the models of random-effects or fixed-effects based. RESULTS: The results of this study will be published at the peer-reviewed journals. It will provide evidence to determine the efficacy and safety of latanoprost for POAG. CONCLUSION: The results of this study will provide helpful evidence for both clinicians and patients, and for the health policy makers to refer for the policy or guideline making. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018115416.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Latanoprosta/uso terapêutico , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisão Sistemática como Assunto , Humanos , Pressão Intraocular/efeitos dos fármacos
10.
Expert Opin Pharmacother ; 19(15): 1731-1738, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30295543

RESUMO

INTRODUCTION: The only evidence-based mechanism for prevention and treatment of glaucomatous optic neuropathy is decreasing the intraocular pressure (IOP). Prescribing multiple ocular hypotensive agents, such as the combination of carteolol and latanoprost, may synergistically improve IOP; however, doing so may increase the complexity of a medication regimen, in turn, impairing patient adherence. Fixed-combination glaucoma medications offer convenience and effectiveness. New to this class of glaucoma medication is fixed combination carteolol-latanoprost (FCCL). Area covered: This review intends to give the reader a better understanding of the efficacy of the combination of carteolol and latanoprost separately, and where FCCL fits into the vast medical arsenal of IOP drops. Furthermore, it outlines the particular pharmacologic mechanisms targeted, the pharmacokinetics, effectiveness, the advantages of fixed-combination administration, and tolerability. Expert opinion: The combination of carteolol and latanoprost, separately or in a fixed-combination, is more effective than either drug alone. Given the early stage in development of FCCL, it has yet to be determined how FCCL compares to other fixed-combination medications. However, pending further approval, fixed-combination carteolol-latanoprost may represent a reasonable alternative for a patient whose IOP is inadequately controlled on a prostaglandin analog alone and for whom a simplified combination is preferred.


Assuntos
Anti-Hipertensivos/uso terapêutico , Carteolol/uso terapêutico , Quimioterapia Combinada/métodos , Glaucoma/tratamento farmacológico , Latanoprosta/uso terapêutico , Hipertensão Ocular/tratamento farmacológico , Anti-Hipertensivos/farmacologia , Carteolol/farmacocinética , Carteolol/farmacologia , Feminino , Humanos , Latanoprosta/farmacocinética , Latanoprosta/farmacologia , Masculino , Resultado do Tratamento
11.
Am J Ophthalmol ; 196: 101-111, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30194929

RESUMO

PURPOSE: The objective was to assess the long-term effect of treatment with latanoprost on ocular development and safety in pediatric patients with glaucoma and ocular hypertension. DESIGN: Prospective cohort study. METHODS: This was a prospective 3-year cohort study conducted in 14 countries in Europe and South America. Patients aged < 18 years with glaucoma or ocular hypertension were enrolled into either the latanoprost or non-prostaglandin (non-PG) group in this observational study. The primary endpoint was change in best-corrected visual acuity (BCVA) from baseline to 3 years. Several secondary endpoints were evaluated, including corneal thickness and ocular hyperpigmentation. For treatment comparison, analysis of covariance (ANCOVA) was used for continuous endpoints and Fisher exact test was applied for proportion of participants with clinically significant deterioration events. RESULTS: A total of 175 patients were enrolled: 102 in the latanoprost group (median follow-up: 36.7 months) and 73 in the non-PG group (median follow-up: 36.1 months). There was no statistically significant difference between the latanoprost and the non-PG groups (aged 5 to <18 years) in BCVA change from baseline (least square mean logMAR difference -0.03 [95% confidence interval: -0.12, 0.06]), corneal thickness, or ocular hyperpigmentation. CONCLUSIONS: Latanoprost had an acceptable safety profile with no evidence of inducing clinically meaningful or statistically significant changes in ocular development or ocular hyperpigmentation in pediatric patients with glaucoma and ocular hypertension.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma/tratamento farmacológico , Latanoprosta/uso terapêutico , Hipertensão Ocular/tratamento farmacológico , Adolescente , Análise de Variância , Anti-Hipertensivos/efeitos adversos , Criança , Pré-Escolar , Feminino , Seguimentos , Glaucoma/fisiopatologia , Humanos , Pressão Intraocular/fisiologia , Latanoprosta/efeitos adversos , Masculino , Hipertensão Ocular/fisiopatologia , Estudos Prospectivos , Acuidade Visual/fisiologia
12.
J Glaucoma ; 27(12): 1175-1180, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30234748

RESUMO

PURPOSE: We prospectively investigated the efficacy and safety of switching from concomitant latanoprost and carteolol hydrochloride (CH) to a latanoprost/carteolol fixed combination (LCFC) in patients with primary open-angle glaucoma or ocular hypertension. PATIENTS AND METHODS: A total of 43 patients (43 eyes) who were using latanoprost (once daily in the evening) and CH (once daily in the morning) concomitantly were switched to LCFC (once daily in the morning) with no washout interval. The primary efficacy endpoint was change in intraocular pressure (IOP) between baseline (before switching) and 1 and 3 months after switching. Systemic blood pressure and pulse rate, corneal epithelial defects, and tear film break-up time (TBUT) were also compared before and 1 and 3 months after switching. A questionnaire was administered 1 month after switching to investigate ocular comfort and treatment preferences. Adverse reactions and dropouts were recorded. RESULTS: There was no significant difference in IOP after switching to LCFC (15.0±2.6, 15.1±2.4, and 15.0±2.4 mm Hg at baseline and at 1 and 3 months, respectively). There was a significant decrease in corneal epithelial defects and significant increase in TBUT, without significant changes in systemic blood pressure or pulse rate. Three patients (7.3%) preferred concomitant latanoprost and CH; 33 (80.5%) preferred the LCFC. One patient each (9.3%) discontinued treatment because of foreign body sensation, blepharitis, increased IOP, or loss to follow-up. CONCLUSIONS: Switching from concomitant latanoprost and CH to LCFC led to similar IOP control with good safety and patient acceptance, at least in the short term.


Assuntos
Anti-Hipertensivos/uso terapêutico , Carteolol/uso terapêutico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Latanoprosta/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/efeitos adversos , Carteolol/efeitos adversos , Combinação de Medicamentos , Substituição de Medicamentos , Quimioterapia Combinada , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular/efeitos dos fármacos , Pressão Intraocular/fisiologia , Latanoprosta/efeitos adversos , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/tratamento farmacológico , Hipertensão Ocular/fisiopatologia , Estudos Prospectivos , Inquéritos e Questionários , Tonometria Ocular , Resultado do Tratamento
13.
Vestn Oftalmol ; 134(4): 91-99, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30166517

RESUMO

The review presents an analysis of therapeutic effectiveness, safety and pharmacokinetics of latanoprost - the reference representative of the prostaglandin group, summarizes the experience of its clinical use in glaucoma as monotherapy and in combination with antihypertensive drugs of other pharmacological groups, its possible effect on the inflammatory process in the anterior segment of the eye, as well as its probable participation in the development of macular edema. The article also gives a recount of relevant local and systemic adverse events.


Assuntos
Glaucoma , Latanoprosta , Prostaglandinas F Sintéticas , Anti-Hipertensivos/uso terapêutico , Glaucoma/tratamento farmacológico , Humanos , Pressão Intraocular , Latanoprosta/uso terapêutico
14.
Sci Rep ; 8(1): 12038, 2018 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-30104599

RESUMO

Glaucoma patients are prone to concomitant ocular surface diseases; however, switching from preserved to preservative-free medication can often alleviate these symptoms. The objective of this study was to examine how the adverse effects and tear proteome change for glaucoma patients (n = 28) during a 12-month drug switch from preserved latanoprost (Xalatan) to preservative-free tafluprost (Taflotan). We hypothesized that patient stratification could help identify novel recovery patterns in both tear proteomics and clinical data. In order to accomplish patient stratification, we implemented sequential window acquisition of all theoretical mass spectrometry (SWATH-MS) as a tool for quantitative analysis of individual tear protein profiles. During each visit (baseline and four follow-up visits), the patients' tears were sampled and the state of their ocular surface was evaluated clinically. Altogether 785 proteins were quantified from each tear sample using SWATH strategy and as these protein expression levels were compared between baseline and 12-month follow-up, three distinct patient groups were identified. We evaluated how these patient groups differed in their protein expression levels at baseline and discovered that the patients with increased levels of pro-inflammatory proteins and decreased levels of protective proteins benefitted most from the medication switch.


Assuntos
Compostos de Benzalcônio/efeitos adversos , Glaucoma/tratamento farmacológico , Conservantes Farmacêuticos/efeitos adversos , Proteoma/análise , Lágrimas/metabolismo , Idoso , Anti-Hipertensivos/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Feminino , Humanos , Latanoprosta/efeitos adversos , Latanoprosta/uso terapêutico , Masculino , Pessoa de Meia-Idade , Prostaglandinas F/efeitos adversos , Prostaglandinas F/uso terapêutico
15.
PLoS One ; 13(8): e0201740, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30080906

RESUMO

PURPOSE: Prostaglandin analogues (PGA's) are the mainstay and first line of treatment in current glaucoma practise. Though latanoprost and bimatoprost are the most commonly used PGA's with minimal side effects at lower concentrations like bimaotoprost 0.01%, direct comparison of their cytokine/MMP profile in tears has not been evaluated earlier. The study intends to ascribe PGA to the upregulation of MMPs, Cytokines and Chemokines mediating varied pathways to result in side effects of the drugs. METHODS: Tear sample collection was done from outer canthus of 30 eyes of 30 patients (primary open angle glaucoma (n = 26 and n' = 20), normal tension glaucoma (n = 4 and n' = 10), in latanoprost (n) 0.005% and bimatoprost (n') 0.01% group respectively, with a mean age of 62±10.5 years) on >6 months of PGA use using Tear floTM Schirmer filter strip. Tear samples from 30 eyes of 30 cataract patients without drug treatment were used as the control. Gelatinolytic activity of MMP-9 and MMP-2 were examined by substrate gelatine zymography MMP-1 and TIMP-1 concentrations from tears samples with PGAs were evaluated by ELISA while cytokine concentration in the eluted tears was evaluated using a convenient bioplex kit assay (Milliplex MAP kit, HCYTMAG-60K-PX41, Millipore, Massachusetts, United States). The mean duration of use of PGA in both groups did not differ significantly (median 1.3 years in bimatoprost and 1.1 years in latanoprost eyes, p = 0.6). RESULTS: The tear MMP-9 expression was higher in eyes receiving latanoprost while the MMP-2 expression was higher in eyes receiving bimatoprost with MMP1 protein levels being higher in the former. Latanoprost treated eyes had marginally elevated tear cytokines involved in tissue remodelling while bimatoprost eyes showed elevated cytokines regulating allergic pathways. CONCLUSION: Differential cytokine and MMP expression indicates differential signalling pathways mediating different cellular effects (evident as clinical and side effects) with the two drugs which can be explored further.


Assuntos
Anti-Hipertensivos/uso terapêutico , Bimatoprost/uso terapêutico , Latanoprosta/uso terapêutico , Lágrimas/efeitos dos fármacos , Lágrimas/metabolismo , Anti-Hipertensivos/efeitos adversos , Bimatoprost/efeitos adversos , Biomarcadores/metabolismo , Catarata/tratamento farmacológico , Catarata/metabolismo , Estudos de Coortes , Citocinas/metabolismo , Feminino , Glaucoma de Ângulo Aberto/tratamento farmacológico , Glaucoma de Ângulo Aberto/metabolismo , Humanos , Latanoprosta/efeitos adversos , Masculino , Metaloproteinase 1 da Matriz/metabolismo , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Pessoa de Meia-Idade
16.
J Glaucoma ; 27(10): 856-863, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30095601

RESUMO

PURPOSE: To investigate the efficacy and safety of a treatment strategy with latanoprost and dorzolamide in primary pediatric glaucoma patients partially responsive to surgery. PATIENTS AND METHODS: Children with primary pediatric glaucoma with postsurgical intraocular pressure (IOP) between 22 and 26 mm Hg were eligible. At baseline, patients were administered latanoprost once daily. Depending on IOP reduction, patients were allocated to continuation of latanoprost monotherapy or addition of dorzolamide twice daily, or switch to dorzolamide monotherapy 3 times daily. Patients in the dorzolamide monotherapy group with IOP reduction <20% from baseline were considered nonresponders. The primary endpoint was the percentage of responders. Study treatment continued for 3 years or until treatment failure. RESULTS: A total of 37 patients (61 eyes) were analyzed. The mean age of the patients was 4.1 years (SD: 3.8). In total, 43 eyes were included in the efficacy analysis. A total of 33 eyes (76.7%; 95% confidence interval, 61.4-88.2) were considered responders: 19 on latanoprost monotherapy, 11 on the latanoprost/dorzolamide combination, and only 3 on the dorzolamide monotherapy. The efficacy of pharmacological treatment was inversely related to central corneal thickness at the time of surgery and the age at the time of surgery. IOP reduction was 9.7 mm Hg (SD: 2.6) for latanoprost, 8.4 mm Hg (SD: 1.5) for the latanoprost/dorzolamide combination, and 9.3 mm Hg (SD: 2.5) for the dorzolamide monotherapy. None of the patients was withdrawn because of adverse events. CONCLUSIONS: Latanoprost alone or in combination with dorzolamide is safe and highly effective in lowering IOP in children after surgery. Nonresponders were mainly patients with early presentation of the disease.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma/tratamento farmacológico , Latanoprosta/uso terapêutico , Sulfonamidas/uso terapêutico , Tiofenos/uso terapêutico , Anti-Hipertensivos/efeitos adversos , Criança , Pré-Escolar , Quimioterapia Combinada , Feminino , Glaucoma/fisiopatologia , Humanos , Lactente , Pressão Intraocular/efeitos dos fármacos , Itália , Latanoprosta/efeitos adversos , Masculino , Hipertensão Ocular/tratamento farmacológico , Estudos Prospectivos , Sulfonamidas/efeitos adversos , Tiofenos/efeitos adversos , Tonometria Ocular , Resultado do Tratamento
17.
J Glaucoma ; 27(11): 976-980, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30113517

RESUMO

PURPOSE: The purpose of this study was to assess the intraocular pressure (IOP) - reducing effect of latanoprost in treatment-naïve patients with newly detected open-angle glaucoma with no restriction of the level of untreated IOP. METHODS: Eighty-six patients (105 eyes) with a diagnosis of open-angle glaucoma received IOP-lowering therapy with latanoprost. The IOP reduction 1 and 3 months after initiation of treatment was recorded. RESULTS: Mean untreated IOP for all eyes was 26.2 mm Hg (ranging from 10 to 51 mm Hg). The mean pressure reduction was 7.9 mm Hg (28%), with equivalent average levels at 1 and 3 months. The reduction in IOP ranged from -2.3 to 25.3 mm Hg after 1 month, and from -1.3 to 33.3 mm Hg after 3 months. The pressure-lowering effect was considerably more pronounced in eyes with higher untreated IOP; the reduction increased by 0.55 mm Hg per mm Hg higher untreated IOP. Four eyes, with untreated IOP within statistically normal limits, had no or negative IOP-reduction. A regression model predicted that IOP reduction ended at untreated IOP≤16 mm Hg. Multiple regression analysis showed that an additional IOP-lowering effect of 1.28 mm Hg was achieved in eyes with pseudoexfoliation glaucoma. CONCLUSIONS: To the best of our knowledge, this paper is the first to report the IOP-reducing effect of latanoprost treatment at all untreated IOP levels in newly detected glaucoma patients. The effect was proportional to the untreated IOP at all levels above 16 mm Hg and better at higher untreated IOP levels, also in relative terms. Our results further confirm the indication of latanoprost as a first-line therapy for glaucoma.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Pressão Intraocular/efeitos dos fármacos , Latanoprosta/uso terapêutico , Idoso , Anti-Hipertensivos/farmacologia , Quimioterapia Combinada , Síndrome de Exfoliação/tratamento farmacológico , Feminino , Humanos , Latanoprosta/farmacologia , Masculino , Pessoa de Meia-Idade , Prostaglandinas F Sintéticas/uso terapêutico , Análise de Regressão , Tonometria Ocular
18.
Adv Ther ; 35(6): 796-808, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29873009

RESUMO

INTRODUCTION: This was the first exploratory randomized controlled study to compare the efficacy and safety of a preserved tafluprost/timolol fixed combination (TAF/TIM) with a preserved latanoprost/timolol fixed combination (LAT/TIM). METHODS: This prospective, randomized, open-label study was conducted in Japanese patients with primary open-angle glaucoma, including normal-tension glaucoma or ocular hypertension. Following a 4-week LAT/TIM run-in period, eligible patients entered a 12-week treatment period, during which they received either LAT/TIM or TAF/TIM. The efficacy endpoint was the change in intraocular pressure (IOP) from baseline to week 12 and the safety endpoints included the changes from baseline to week 12 in superficial punctate keratopathy (SPK) score, tear breakup time (TBUT), and hyperemia score, as well as adverse events (AEs). At week 6, ocular symptoms were evaluated using a questionnaire. RESULTS: In total, 131 patients provided informed consent. Of these, 115 completed the run-in period and were assigned to receive TAF/TIM (n = 60) or LAT/TIM (n = 55). At week 12, there were no significant differences between the TAF/TIM and LAT/TIM groups in the change from baseline in trough IOP and IOP at 4-6 h after instillation. There were no significant differences between the two groups in the change from baseline to week 12 in SPK score, TBUT, and hyperemia score. However, only in the TAF/TIM group, the total SPK score and the inferior cornea SPK score were significantly lower at week 12 compared with baseline. Eye irritation and eye pain were significantly decreased in the TAF/TIM group compared with the LAT/TIM group. Two treatment-related AEs were reported in the TAF/TIM group (3.3%) and none in the LAT/TIM group, while no serious AEs were reported in either group. CONCLUSION: TAF/TIM is as effective as LAT/TIM in terms of IOP-reducing effect, with fewer ocular symptoms. TAF/TIM was associated with a significant improvement in SPK scores. TRIAL REGISTRATION: UMIN Clinical Trials Registry Identifier, UMIN000023862. FUNDING: Santen Pharmaceutical Co., Ltd., Osaka, Japan.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Latanoprosta/uso terapêutico , Glaucoma de Baixa Tensão/tratamento farmacológico , Hipertensão Ocular/tratamento farmacológico , Prostaglandinas F/uso terapêutico , Timolol/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Combinação de Medicamentos , Feminino , Humanos , Pressão Intraocular/efeitos dos fármacos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Prostaglandinas F Sintéticas/uso terapêutico , Timolol/efeitos adversos , Tonometria Ocular , Adulto Jovem
19.
Arch Soc Esp Oftalmol ; 93(10): 511-514, 2018 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29910082

RESUMO

CLINICAL CASE: The case concerns an 81-year-old woman on treatment with a topical fixed combination of timolol and brimonidine who was diagnosed in the Emergency Department with acute anterior granulomatous hypertensive uveitis. The patient responded favourably to the withdrawal of the eye drops without showing any subsequent relapse. DISCUSSION: Uveitis due to brimonidine is a rare adverse effect, but it must be known. Once the diagnosis is suspected, the effective treatment is the withdrawal of brimonidine, with or without the addition of topical corticosteroids to control inflammation depending on the severity of the condition. It is a process with an excellent prognosis.


Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/efeitos adversos , Tartarato de Brimonidina/efeitos adversos , Soluções Oftálmicas/efeitos adversos , Uveíte Anterior/induzido quimicamente , Doença Aguda , Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Idoso de 80 Anos ou mais , Tartarato de Brimonidina/uso terapêutico , Conjuntivite Alérgica/induzido quimicamente , Ciclopentolato/uso terapêutico , Quimioterapia Combinada , Epitélio Anterior/patologia , Feminino , Glaucoma de Ângulo Aberto/tratamento farmacológico , Granuloma/induzido quimicamente , Humanos , Latanoprosta/uso terapêutico , Lubrificantes Oftálmicos , Hipertensão Ocular/induzido quimicamente , Prednisolona/análogos & derivados , Prednisolona/uso terapêutico , Sulfonamidas/uso terapêutico , Tiofenos/uso terapêutico , Timolol/uso terapêutico , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico
20.
J Glaucoma ; 27(7): 635-637, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29750717

RESUMO

PURPOSE: The purpose of this study was to evaluate the changes in choroidal thickness during the use of latanoprost eyedrops which shift fluid to the suprachoroidal space and change choroidal perfusion. MATERIALS AND METHODS: This prospective study included 34 eyes of 17 bilateral glaucoma or ocular hypertensive patients who had no previous hypotensive therapy. Each patient had both eyes treated with latanoprost. Each patient also underwent a complete ophthalmological examination and optical coherence tomography measurement. Choroidal thickness measurements by optical coherence tomography were carried out on the first visit before latanoprost use and at time intervals of 7 and 30 days of therapy. RESULTS: The patients' mean age was 62.3±11 years (range, 30 to 83 y). Of 17 patients, 7 were female individuals. There were no significant differences in central choroidal thicknesses at the fovea, or at each point within the horizontal nasal and temporal quadrants between visits (P<0.05 for all comparisons). CONCLUSIONS: The current study showed that choroidal thickness does not change after latanoprost therapy. However, the choroidal changes of anterior part of the eye can be effected by the latanoprost therapy. Future studies investigating the anterior part of the eye and focusing on both choroidal perfusion and choroidal thickness may give additional information concerning the mechanism of action.


Assuntos
Corioide/efeitos dos fármacos , Corioide/patologia , Glaucoma/tratamento farmacológico , Latanoprosta/farmacologia , Hipertensão Ocular/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fóvea Central/diagnóstico por imagem , Fóvea Central/efeitos dos fármacos , Fóvea Central/patologia , Glaucoma/diagnóstico , Glaucoma/patologia , Glaucoma/fisiopatologia , Humanos , Pressão Intraocular/efeitos dos fármacos , Latanoprosta/uso terapêutico , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/diagnóstico , Hipertensão Ocular/patologia , Hipertensão Ocular/fisiopatologia , Tamanho do Órgão/efeitos dos fármacos , Estudos Prospectivos , Tomografia de Coerência Óptica/métodos
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