개방각녹내장 환자에서 비마토프로스트(0.03%)와 티몰롤(0.5%) 혼합 제제의 효능과 안정성
Efficacy and Safety of a Fixed Combination of Bimatoprost (0.03% w/v) and Timolol (0.5% w/v) for Patients with Open-angle Glaucoma
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목적: Bimatoprost (0.03%)와 timolol (0.5%) 혼합 제제(Ganfort®, Allergan, Inc, Irvine, CA, USA; fixed combination of bimatoprost/ timolol, BTFC)를 점안하는 개방각녹내장 환자들의 안압하강 효과, 안정성을 평가하였다. 대상과 방법: 개방각녹내장이 진단되어 녹내장 약을 사용하던 25명의 환자들의 우안을 대상으로 하였다. 기존에 사용하던 녹내장 약을 휴약기 없이 BTFC로 변경하였고, 변경 전 안압과 변경 후 1, 4, 7, 10개월 후 안압을 비교하여 효과 및 부작용을 평가하였다. 결과: BTFC를 점안하였을 때 점안 전 평균 안압과 점안 후 안압하강 수치는 각각 1달 후 “18.66 ± 8.22” mmHg (n=21), “2.47 ± 3.19” mmHg (13.24%), 4달 후 “19.05 ± 8.54” mmHg (n=18), “3.68 ± 5.55” mmHg (19.32%), 7달 후 “16.68 ± 2.52” mmHg (n=16), “2.13 ± 2.87” mmHg (12.77%), 10달 후 “20.07 ± 9.91 mmHg” (n=14), “2.79 ± 4.48” mmHg (13.90%)였다(p<0.05). 부작용으로따가움(2명, 7.7%), 결막충혈, 가려움(3명, 11.5%), 불편감(3명, 11.5%)이 나타났고, 영구적 시력 손상을 유발하는 부작용 또는 전신부작용을 호소하는 환자는 없었다. 결론: BTFC는 개방각녹내장 환자에서 안압을 효과적으로 감소시키며, 약제로 인해 전신 합병증을 호소하거나 영구적인 시력저하를일으키는 안구손상이 나타난 환자는 없었다.
Abstract
Purpose: We investigated the efficacy and safety of a fixed combination of bimatoprost (0.03% w/v) and timolol (0.5% w/v) (Ganfort ® , Allergan Inc., Irvine, CA, USA; fixed combination of bimatoprost-timolol, BTFC) for open-angle glaucoma patients. Methods: We included 25 right eyes with open-angle glaucoma treated with eye drops. The drops were changed to the BTFC without a wash-out period. The therapeutic and adverse effects were evaluated by comparing the intraocular pressure (IOP) before the change to that at 1, 4, 7, and 10 months thereafter. Results: The mean IOP before the instillation of eyedrop and the mean reduction of IOP at each time was 18.66 ± 8.22 mmHg (n = 21) and 2.47 ± 3.19 mmHg (13.24%) at 1 month, 19.05 ± 8.54 mmHg (n = 18) and 3.68 ± 5.55 mmHg (19.32%) at 4 months, 16.68 ± 2.52 mmHg (n = 16) and 2.13 ± 2.87 mmHg (12.77%) at 7 months, and 20.07 ± 9.91 mmHg (n = 14) and 2.79 ± 4.48 mmHg (13.90%) at 10 months (p < 0.05). Side effects included soreness (two eyes, 7.7%), red eye and allergic symptoms (three patients, 11.5%), and discomfort (three patients, 11.5%); there were no severe adverse events such as permanent vision loss or systemic side effects. Conclusions: BTFC reduced the IOP of open-angle glaucoma patients without causing permanent vision loss or any other serious side effects.
참고문헌 (23)
- Resnikoff S, "Global data on visual impairment in the year 2002", Bull World Health Organ, 82, pp.844~851 (2004)
- Kingman S, "Glaucoma is second leading cause of blindness globally", Bull World Health Organ, 82, pp.887~888 (2004)
- Collaborative Normal-Tension Glaucoma Study Group, "Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures", Am J Ophthalmol, 126, pp.487~497 (1998)
- Kass MA, "The ocular hypertension treatment study : a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma", Arch Ophthalmol, 120, pp.701~713 (2002)
- Friedman DS, "An evidence-based assessment of risk factors for the progression of ocular hypertension and glaucoma", Am J Ophthalmol, 138(3 Suppl), pp.S19~31 (2004)
- Heijl A, "Reduction of intraocular pressure and glaucoma progression : results from the early manifest glaucoma trial", Arch Ophthalmol, 120, pp.1268~1279 (2002)
- Lichter PR, "Interim clinical outcomes in the collaborative initial glaucoma treatment study comparing initial treatment randomized to medications or surgery", Ophthalmology, 108, pp.1943~1953 (2001)
- Rotsos TG, "Bimatoprost", timolol fixed combination(BTFC)in patients with primary open angle glaucoma or ocular hypertension in Greece, 2016, pp.9, 69~75
- 심성희, "Diurnal Intraocular Pressure with Bimatoprost", Timolol Fixed Combination versus Latanoprost, Korean Journal of Ophthalmology, pp.2014, 28(1)[DOI]
- Deepak Mishra, "Comparing the Efficacy of Latanoprost (0.005%), Bimatoprost (0.03%), Travoprost (0.004%), and Timolol (0.5%) in the Treatment of Primary Open Angle Glaucoma", Korean Journal of Ophthalmology, 28(5), pp.399~407 (2014), 대한안과학회
- Tang W, "Efficacy and safety of prostaglandin analogues in primary open-angle glaucoma or ocular hypertension patients: a meta-analysis", Medicine(Baltimore), 98, pp.e16597~ (2019)
- Yavaş GF, "Comparison of latanoprost, brimonidine tartrate, and bimatoprost plus timolol maleate in fixed combinations", Turk J Med Sci, 43, pp.321~325 (2013)
- Herreras JM, "Ocular surface alteration after long-term treatment with an antiglaucomatous drug", Ophthalmology, 99, pp.1082~1088 (1992)
- Konstas AG, "Diurnal intraocular pressure reduction with latanoprost 0.005% compared to timolol maleate 0.5% as monotherapy in subjects with exfoliation glaucoma", Eye(Lond), 18, pp.893~899 (2004)
- Williams DE, "Effects of timolol, betaxolol, and levobunolol on human tenon's fibroblasts in tissue culture", Invest Ophthalmol Vis Sci, 33, pp.2233~2241 (1992)
- Feldman RM, "Conjunctival hyperemia and the use of topical prostaglandins in glaucoma and ocular hypertension", J Ocul Pharmacol Ther, 19, pp.23~35 (2003)
- Parrish RK, "A comparison of latanoprost, bimatoprost, and travoprost in patients with elevated intraocular pressure : a 12-week, randomized, masked-evaluator multicenter study", Am J Ophthalmol, 135, pp.688~703 (2003)
- Goldberg I, "Bimatoprost 0.03%", timolol 0.5% preservative-free ophthalmic solution versus bimatoprost 0.03%, Br J Ophthalmol, pp.2014, 98[DOI]
- Lama PJ, "Systemic adverse effects of beta-adrenergic blockers : an evidence-based assessment", Am J Ophthalmol, 134, pp.749~760 (2002)
- Quaranta L, "Effects of topical hypotensive drugs on circadian IOP, blood pressure, and calculated diastolic ocular perfusion pressure in patients with glaucoma", Invest Ophthalmol Vis Sci, 47, pp.2917~2923 (2006)
- Costagliola C, "Circadian changes of intraocular pressure and ocular perfusion pressure after timolol or latanoprost in Caucasians with normal-tension glaucoma", Graefes Arch Clin Exp Ophthalmol, 246, pp.389~396 (2008)
- Avorn J, "Adverse pulmonary effects of topical beta blockers used in the treatment of glaucoma", J Glaucoma, 2, pp.158~165 (1993)
- Harris A, "The impact of glaucoma medication on parameters of ocular perfusion", Curr Opin Ophthalmol, 12, pp.131~137 (2001)