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G. Kobelt, B. Richard, P. Buchholz, A. Bron, J.-P. Renard, J.-F. Rouland, J.-P. Nordmann; Treatment of Glaucoma in Clinical Practice: 4-year Results From a Patient Registry in France. Invest. Ophthalmol. Vis. Sci. 2009;50(13):418.
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To investigate long-term resource consumption and clinical outcome for patients with early primary open-angle glaucoma or ocular hypertension treated with prostaglandin analogues/prostamides in clinical practice in France.
34 geographically spread specialized hospitals and private practices enrolled consecutive patients receiving for the first time a prostaglandin analogue/prostamide, alone or in combination. The study was based on routine practice and no consultations, examinations or treatments were mandated by the protocol. Treating physicians recorded each consultation, including all examinations performed, referrals, admissions and prescriptions. Descriptive analysis of resource consumption and development of IOP and visual fields was performed, for all patients who completed the 4 year follow-up.
The study enrolled 602 patients and 78% completed 4-years follow-up. Mean age was 65 years, and mean time since diagnosis 4 years. Mean IOP was reduced from a baseline of 21.2 mmHg to 16.5 mmHg during the first year and remained stable throughout the study. Mean visual fields at baseline were -4.2 MD and stable during the follow-up. Total mean health care costs per patient were €1947, of which medication represented 50%. Over half of the patients (52%) remained on their initial medication during the 4 years. Drug changes were mostly due to inadequate IOP control, and the number of treatment switches was significantly related to costs.
This is the first prospective study of treatment with prostaglandins in clinical practice. The results indicate that many patients with early glaucoma managed primarily with prostaglandin analogues/prostamides will show very little progression over 4 years. Compared to the mid-nineties, costs have not increased despite the higher acquisition cost of prostaglandin analogues/prostamides, as surgical interventions and medical consultations have decreased.
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