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G. Kobelt, B. Richard, A. Bron, J. P. Nordmann, J. P. Renard, J. F. Rouland, P. Buchholz; Treatment of Glaucoma in Clinical Practice: Two Year Follow-Up From an Internet-Based Patient Registry in France. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2404.
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To investigate long-term resource consumption related to the use of three IOP-lowering topical treatments (latanoprost, travoprost, bimatoprost).
The study included 601 patients in 37 centers, that at baseline received one of the three treatments for the first time, alone or in combination. The patients are being followed during an ongoing, 4-year naturalistic observational study, and results at the 2-year mark are presented. Data are collected directly on an internet-based study site. All disease- or treatment-related consumption is recorded, as are IOP and test results, for both eyes. Outcome is assessed based on the worse eye.
Mean follow-up was 36.5 months and complete 24 months data were available for 568 patients. Baseline distribution was 45% latanoprost, 24% travoprost, 31% bimatoprost. Around 21% of patients were treatment naïve, while 10% started on combination treatment. Mean age was 65 years (SD 12.3) and mean time since diagnosis 4.2 years. Total mean costs per patient were 1286 €. During the 2 first years, patients had 3.7 visits (excluding baseline); 32.4% required a treatment change, and 7.3% underwent surgery. Patients with a treatment change had higher around 30% costs (1521 € compared to 1174 €). The most marked increases were due to hospitalization and in- and outpatient surgery. The mean IOP in the worse eye was 21.3 mmHg at baseline and 16.1 mmHg after 2 years. The proportion of patients reaching a target level of < 15 mmHg was 42% in the bimatoprost and travoprost groups, however treatment changes and surgery were most frequent in the travoprost group. This proportion was significantly lower in the latanoprost group (26%), which however contained the largest proportion of patients starting on combination after previous prostaglandin monotherapy.
Overall, this interim analysis shows similar outcomes in the 3 groups, but treatment was changed in around one fifth of patients to achieve this result. There were no major differences in the way patients were managed.
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