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V. W. Istiantoro, R. Sasikumar, F. Oen, S. T. Hoh, C. L. Ho, T. Aung; Efficacy and Safety of a Systematic Switch From Latanoprost to Travoprost in Patients With Glaucoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4825.
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After a tender for prostaglandin analogs, glaucoma patients previously treated with latanoprost were systematically switched to travoprost. The switch was a systematic switch and not based on intolerance or poor response to latanoprost. The aim of this study was to assess the efficacy and safety of systematically switching a large number of hospital-based glaucoma patients from latanoprost to travoprost therapy.
In this prospective non-randomized, observational case-series, patients on latanoprost were systematically switched to travoprost without washout and followed up for 12 weeks. The main outcome measures were intraocular pressure (IOP), rate of switching back and tolerability. IOP was measured at baseline (while on latanoprost), and at weeks 6 and 12 after switching to travoprost. Adverse effects were assessed and conjunctival hyperemia was graded using a standardized scale as 0 (none to trace), 1 (mild), 2 (moderate) and 3 (severe). At the final visit, all patients were subjected to a questionnaire that enquired about comfort of use and their assessment of degree of hyperemia.
Ninety-three consecutive patients were enrolled; data was analyzed for 82 subjects. The mean age was 62.9 ± 11.9 years (25-87 years). Majority of the patients were Chinese (89%); there were 47 males (57.3%). The mean IOP at baseline (16.92 ± 3.81 mm Hg) was not statistically different from that at week 6 (15.86 ± 4.21 mm Hg) (p=0.10) or week 12 (16.34 ± 5.69 mm Hg) (p=0.25). Forty-six patients (58.2%) showed no change in the hyperemia scores at week 12, while 21 (26.5%) had an increase in hyperemia by 1 grade. There were 11 patients (13.9%) who showed improvement of hyperemia by 1 grade. Sixty-six patients (83.5%) felt that subjectively, both drugs were the same in terms of comfort and degree of redness. Ten patients (12.6%) felt that latanoprost was better tolerated and 3 patients (3.8%) felt travoprost was more comfortable. None of the patients exited the study due to hyperemia. Three patients were switched back to latanoprost after 6 weeks due to travoprost intolerance; eight were lost to follow-up.
When glaucoma patients were systematically switched from latanoprost to travoprost, the efficacy and safety of the 2 medications were found to be comparable with few of them switching back.
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