Abstract
Purpose :
To evaluate the early efficacy and utility of latanoprostene bunod 0.024% (LBN), a new class of drug for reducing IOP, in clinical practice. The US FDA approved LBN in November 2017. LBN became available for clinical use in January 2018.
Methods :
Retrospective EMR review identified all open angle glaucoma (OAG) and ocular hypertensive (OHT) patients undergoing treatment with LBN by 4 glaucoma specialists (JS, DG, NS, and JT) at the Icahn School of Medicine at Mount Sinai Faculty Practice from January 2018 to January 2019. Each patient’s IOP and medications were recorded for 2 visits prior to treatment with LBN, for their first visit on LBN, and for their most recent visit on LBN. Statistical analysis including paired t-test was performed using Excel. IRB approval was obtained.
Results :
EMR of 52 patients were reviewed: 27 M & 25 F, 18 white, 5 black, 1 Asian, 1 Native American, 2 multiracial, 25 unknown/other, age (mean±SD) 68.5±11.9 years. Prior to LBN prescription there was a mean IOP increase of 1.6±3.1 mmHg. IOP at the visit prior to starting LBN was 16.6±3.8 mmHg on 3.1±1.4 glaucoma medications. Post-treatment IOP at the most recent visit was 14.4±4.1 on 3.1±1.4 medications; mean IOP reduction on LBN was 2.2±2.9 mmHg (P<.001). IOP was reduced ≥2 mmHg (on 3.5 meds) in 52%, by ≥3 mmHg (on 3.6 meds) in 41% and by ≥4 mmHg (on 3.5 meds) in 30% of eyes. 48/52 patients received LBN as replacement for a prostaglandin, and 4 received LBN who were not previously on a prostaglandin. Treatment duration was 122±77 days. 32 patients remained on LBN throughout the follow-up period. 8 were discontinued for lack of efficacy, 4 for adverse effects including pain and itching, 4 for financial reasons, and 4 for other reasons.
Conclusions :
In the first year of clinical use of LBN at Mount Sinai, reductions in IOP were clinically and statistically significant in >50% of patients. LBN was additive to other medications and was well-tolerated in most patients. Our results suggest LBN is an effective and useful drug for treatment of patients with elevated IOP. Further research on LBN’s efficacy in lowering IOP in clinical settings is warranted.
This is a 2020 ARVO Annual Meeting abstract.