Abstract
Purpose::
To determine efficacy one year after a mass switch from latanoprost 0.005% to travoprost 0.004% in glaucoma patients at the Manhattan VA.
Methods::
Retrospective review of chart data identified through pharmacy records of glaucoma patients switched from latanoprost to travoprost between August, 2003 and April, 2004. Patients diagnosed as having chronic open angle glaucoma (COAG), pigment dispersion glaucoma (PDG), pseudoexfoliation glaucoma (PXG), normal tension glaucoma (NTG) or ocular hypertension (OHTN) were included. All patients were seen and evaluated in the glaucoma clinic at the Manhattan VA. Intraocular pressure (IOP) was measured in the afternoon on all visits. Patients could be on monotherapy with latanoprost or concomitant therapy in addition to latanoprost prior to the switch to travoprost. No other changes in regimen were permitted other than the switch to travoprost.
Results::
178 eyes of 97 patients (96 male, 1 female, mean age 75.5 +/- 11yrs) were identified. In the monotherapy group (66 eyes of 37 pts.), mean IOP at baseline was 15.7+/-4.3 mmHg. At 6 mos. IOP was 15.2+/-3.3mmHg (p>0.05) and at 1 yr. 15.2+/-3.5mmHg (p>0.05). 14 eyes (10 pts.) showed an IOP lowering >3mmHg and 8 eyes (4 pts.) showed an IOP increase >3mmHg at 1 year. In the concomitant therapy group (112 eyes of 60 pts.), mean IOP at baseline was 15.9+/-4.5mmHg. At 6 mos. IOP was 14.6+/-3.8mmHg (p=0.013) and at 1 yr. 14.5+/-3.9mmHg (p=0.008). 26 eyes (20 pts.) showed an IOP lowering >3mmHg and 3 eyes (3 pts.) showed an IOP increase >3mmHg at 1 yr. No patients were switched back by 1 yr.
Conclusions::
Switching from latanoprost to travoprost is safe and at least as effective in glaucoma patients. A statistically significant reduction in mean IOP was seen in the concomitant therapy group but not the monotherapy group at 1 yr. Many patients have an additional IOP lowering effect >3mmHg at 1 yr. after the switch, especially when on multiple medications.
Keywords: intraocular pressure • drug toxicity/drug effects