Abstract
Purpose :
To investigate the response profile of latanoprostene bunod (LBN) 0.024% in a clinic-based setting
Methods :
This was a retrospective chart review study. We screened the electronic medical records of patients who had visited a glaucoma practice at the New York Eye and Ear Infirmary of Mount Sinai between 1/1/2018 to 12/31/2018. We included 34 eyes of 34 patients with primary open-angle (POAG) and normal-tension glaucoma (NTG). We selected patients ≥ 18 years who had received LBN 0.024% once daily for a minimum of twelve successive days in substitution for a prostaglandin analog (PGA). Exclusion criteria were the use of steroids of any type within the timeline of LBN use, the use of additional anti-glaucoma medication after initiation of LBN, increasing the dosage of steroids in patients currently using steroids, and any IOP lowering procedures including laser therapy. Patients were divided into three groups: responder, non-responder, and paradoxical responder. We defined them as IOP change of ≥ 2 mmHg decrease, <2 mmHg “change”, and ≥ 2mmHg increase in IOP from the baseline, respectively. We measured the responder, non-responder and paradoxical responder rate of LBN use. The multiple linear regression adjusted by age, diagnosis and baseline IOP was used to evaluate the percentage of IOP change among the three groups.
Results :
Of the 34 patients, 32.3%, 47.1%, and 20.6% were responders, non-responders, and paradoxical responders respectively. Baseline IOPs were 16.2±4.2, 17.4±3.7, and 20.4±5.7 mmHg for responders, non-responders (p=1.000), and paradoxical responders (p=0.154) respectively. The duration of LBN use was 65.5±74.8, 41.5±29.2, and 54.6±49.95 days for responders, non-responders (p=1.000), and paradoxical responders (p=1.000) respectively. Percentage of IOP change was -21.17 ± 8.79%, -3.05 ± 4.62%, and 26.70 ± 9.47% in responders, non-responders, and paradoxical responders respectively (p<0.001). In multivariable analysis, the percentage of IOP change in the responder group was significantly lower compared to those in the non-responder group (mean difference = -19.18, 95 % CI = -25.89, -12.46, P<0.001).
Conclusions :
Our data does not justify switching of a PGA to LBN to achieve further IOP lowering effect in patients on multiple medical therapies.
This is a 2020 ARVO Annual Meeting abstract.