Latanoprostene bunod ophthalmic solution 0.024% in patients with glaucoma or ocular hypertension new to pharmacotherapy

Abstract

Purpose : The intraocular pressure (IOP)-lowering efficacy of latanoprostene bunod 0.024% (LBN), a nitric oxide-donating prostaglandin analog, has been demonstrated in multiple studies in subjects with open-angle glaucoma (OAG) or ocular hypertension (OHT). We evaluated real-world effectiveness of LBN in patients newly diagnosed with glaucoma or OHT new to pharmacotherapy.

Methods : This was a multicenter retrospective chart review. Patients were aged ≥18 years with no prior history of medical or surgical IOP-lowering intervention and at least two follow-up visits (spanning ≥2 months) following initiation of LBN treatment. Data extracted from patient charts included age, sex, race, cup-to-disk ratio (CDR), central corneal thickness, adverse events (AEs), IOP, and visual acuity (VA). If LBN was used in both eyes, the eye with the higher IOP at baseline was considered the study eye. Paired t-tests were used to compare IOPs at baseline and after starting LBN.

Results : Data for 125 eyes (n=65 patients) treated with LBN were reviewed across 9 clinical sites. Mean (SD) age of patients was 59 (14) years, and most (53.8%) were female. Mean CDR at baseline was 0.6 (range: 0.15 to 0.9) and mean (SD) IOP at baseline was 21.7 (5.9) mm Hg. The mean days to 1^st and 2^nd follow-up visit was 43 and 141 days, respectively. LBN use resulted in a mean (SD) reduction from baseline of 7.1 (4.6) and 7.3 (5.1) mm Hg at the 1^st and 2^nd follow-up visit, respectively (P<0.001 for both vs baseline). Reductions among the subset of patients with elevated IOP (>21 mm Hg; n=30) were 10.0 (4.5) and 11.1 (4.6) mm Hg at the 1^st and 2^nd follow-up visit (P<0.001 for both vs baseline). At the 2^nd follow-up visit, the proportion of patients achieving an IOP reduction of ≥25% from baseline was 66.2% overall and 83.3% in the patients with elevated IOP at baseline. A reduction of ≥40% from baseline was achieved by 29.2% of patients overall and 53.3% of the patients with elevated IOP at baseline. There were no meaningful changes in VA. Reports of AEs were infrequent, and only one patient reported ocular redness in one eye (0.8%).

Conclusions : In this real-world effectiveness study, LBN use resulted in robust IOP-lowering in patients newly diagnosed with glaucoma or OHT new to pharmacotherapy and was well-tolerated. The IOP-lowering of effect of LBN was comparable to that seen in previous randomized controlled trials.

This is a 2020 ARVO Annual Meeting abstract.