June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Proportion of Non-Responders to Beta-blockers and Prostaglandin Analogs in OHTS, CIGTS, and Enrollees in a United States Managed Care Plan.
Author Affiliations & Notes
  • Matthew G J Trese
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI
  • Andrew Lewis
    Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO
  • David M Reed
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI
  • Taylor Blachley
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI
  • Michael A Kass
    Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO
  • David C Musch
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI
  • Mae O Gordon
    Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO
  • Joshua D Stein
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI
  • Sayoko Eileen Moroi
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI
  • Footnotes
    Commercial Relationships Matthew Trese, None; Andrew Lewis, None; David Reed, RPB (F); Taylor Blachley, None; Michael Kass, NIH (F); David Musch, NEI (F); Mae Gordon, NIH (F); Joshua Stein, NEI (F); Sayoko Moroi, NEI (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5694. doi:
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      Matthew G J Trese, Andrew Lewis, David M Reed, Taylor Blachley, Michael A Kass, David C Musch, Mae O Gordon, Joshua D Stein, Sayoko Eileen Moroi; Proportion of Non-Responders to Beta-blockers and Prostaglandin Analogs in OHTS, CIGTS, and Enrollees in a United States Managed Care Plan.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5694.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To estimate the proportion of patients diagnosed with ocular hypertension or open angle glaucoma who do/do not respond following initial treatment with either topical beta-blockers (BB) or prostaglandin analogs (PGA).

Methods: We analyzed three datasets - the Ocular Hypertension Treatment Study (OHTS), (1994-1996), the Collaborative Initial Glaucoma Treatment Study (CIGTS), (1993-1997), and the Clinformatics Data Mart Database (2001-2012), a claims database of all eye care recipients in a large managed care network. For patients in OHTS and CIGTS, percent intraocular pressure change (%∆IOP) was calculated by [(treated IOP - baseline IOP)/baseline IOP]*100. Non-response was defined as %∆IOP less than -15%. For the Clinformatics dataset, patients with ocular hypertension / glaucoma were identified by ICD-9-CM codes and we identified newly prescribed BBs or PGAs. Non-response was defined as the addition of another class of ocular hypotensive medication, incisional or laser glaucoma surgery, or cessation of all treatment for glaucoma within 1 year.

Results: The initial treatment for most of the OHTS and CIGTS subjects was BB. In the 741 OHTS subjects started on BB, 27% were non-responders at the 6-month visit. Among the 286 CIGTS subjects started on BB, 17% were non-responders at the 3 month follow up visit. In the Clinformatics dataset, 39% of the 1,392 patients started on a BB were classified as “non-responders.” Of the 12,154 patients started on PGA, 29% were “non-responders.”

Conclusions: Despite differences in OHTS, CIGTS and the Clinformatics database and differences in “non-responder” definition, the proportion of non-responders to BB were surprisingly in a similar range (17-39%) that is consistent with clinical experience. Analysis is underway to assess the economic impact of non-response in the first year of treatment. Understanding the genetic and environmental causes of BB and PGA non-responders will enable an individualized treatment approach.

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