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S. H. McKinley, R. Singh, S. Orengo-Nania; Intraocular Pressure Control and Incidence of Travoprost-Attributed Adverse Effects Among Patients Switched From Latanoprost to Travoprost at a Veterans Affairs Medical Center Eye Clinic. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5558.
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To assess intraocular pressure (IOP) control and the incidence of travoprost-attributed adverse effects in patients switched from latanoprost to travoprost.
The electronic medical record system at the Michael E. DeBakey VA Medical Center (MEDVAMC) was retrospectively reviewed after obtaining IRB approval at Baylor College of Medicine. Patients using latanoprost before the MEDVAMC drug formulary switch from latanoprost to travoprost had to meet inclusion criteria. Main outcome measurements consisted of IOP control upon switching from latanoprost to travoprost and whether a patient reported ocular side effects while using travoprost. If a patient who tolerated latanoprost reported ocular side effects while using travoprost, then IOP control was examined in those eyes switched back to latanoprost as a secondary outcome measurement. Data collected consisted of IOP measurements, patient age/gender/ethnicity, the indication for treatment with a prostaglandin analog (PGA) and any adverse effect reported while using travoprost. Mean IOP and mean change in IOP for eyes receiving a change in PGA were calculated and analyzed.
One thousand seven hundred seventy-four (1,774) patients received latanoprost from the MEDVAMC in the initial patient database. Eight hundred patients (800) were included for review. There were 780 males and 20 females with a mean age of 72.0 years. Primary open angle glaucoma was the most common indication for treatment with a PGA. Mean IOP on latanoprost was 15.3 mmHg (1,075 eyes) and 15.5 mmHg on travoprost (1,050 eyes.) The within-subject mean change in IOP was 0.18 mmHg (SD=3.2 mmHg), which was not statistically significant per the paired t-test (p = 0.0707). When analyzing using the worse eye (eye with the higher IOP before the switch), the within-subject mean change in IOP was -0.09 mmHg (p = 0.4832, 601 eyes). While on travoprost, 31 patients (3.88%) reported experiencing one or more ocular side effects (burning, redness, irritation, itching, or swelling.) A total of 20 patients (2.5%; 39 treated eyes) returned to latanoprost. Their within-subject mean change in IOP from latanoprost to travoprost was 0.80 mmHg (p = 0.4411, 30 eyes), and -0.67 mmHg (p = 0.4591, 30 eyes) from travoprost to latanoprost.
No statistically significant difference between travoprost and latanoprost in maintaining IOP control exists in our patient population. Travoprost was well tolerated with only a small percentage of patients experiencing mild ocular side effects.
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