도졸라마이드/티몰롤 혼합 제제를 사용 중인 원발개방각녹내장에서 프로스타글란딘 제제 추가 시 효과
Add-on Effect of Prostaglandin Analogues in Dorzolamide/Timolol Fixed Combination Treated Primary Open Angle Glaucoma Patients
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목적: 도졸라마이드/티몰롤 복합 제제(2% dorzolamide/0.5% timolol fixed combination, DTFC)를 사용 중인 원발개방각녹내장(primary open angle glaucoma, POAG)에서 서로 다른 프로스타글란딘 제제를 추가하였을 경우 안압 하강 효과와 안정성을 비교하였다. 대상과 방법: DTFC를 사용 중인 POAG 환자 중 추가 안압 하강이 필요하여 라타노프로스트, 트라보프로스트 또는 비마토프로스트를추가한 환자를 대상으로 의무기록을 후향적으로 조사하였다. 프로스타글란딘 제제를 추가하기 전과 후의 안압, mean deviation, 약제부작용을 비교 분석하였다. 결과: 라타노프로스트를 추가한 후 12개월째 평균 안압은 18.6 ± 1.3 mmHg로 추가하기 전과 비교하여 15.8%의 추가 안압 하강 효과가 나타났다. 트라보프로스트를 추가한 경우 평균 안압은 18.2 ± 1.5 mmHg로 16.9%의 추가 안압 하강 효과, 비마토프로스트를 추가한 경우 평균 안압은 18.1 ± 1.5 mmHg로 17.0%의 추가 안압 하강 효과가 나타났다. 세 군 사이에 추가 안압 하강 효과는 통계적으로유의한 차이를 보이지는 않았다. 세 군 모두에서 가장 흔한 부작용은 결막 충혈이었으며 약제를 중단할 만한 심각한 약제 부작용은발생하지 않았다. 결론: DTFC를 사용 중인 POAG 환자에서 라타노프로스트, 트라보프로스트, 비마토프로스트 추가 시 세 가지 약제에서 15.8-17.0%의추가 안압 하강 효과를 나타냈다.
Abstract
Purpose: To evaluate the additive intraocular pressure (IOP)-lowering effect of three different prostaglandin analogues in dorzolamide/ timolol fixed combination (DTFC)-treated primary open angle glaucoma (POAG). Methods: In this retrospective chart review, adjunctive latanoprost, travoprost, or bimatoprost were administered in DTFC-treated POAG patients who required additional IOP-lowering treatment. IOP, mean deviation value, and adverse drug reactions (ADRs) were evaluated. Results: In the latanoprost group, the baseline IOP was 22.1 ± 1.3 mmHg. The mean IOP after 12 months of adjunctive latanoprost was 18.6 ± 1.3 mmHg and the reduction rate was 15.8% (p = 0.000). In the travoprost group, the mean IOP after adjunct travoprost was 18.2 ± 1.5 mmHg and the reduction rate was 16.9% (p = 0.000). In the bimatoprost group, the mean IOP and reduction rate were 18.1 ± 1.5 mmHg and 17.0%, respectively (p = 0.000). There were no significant differences in the additional IOP reduction rate among the three groups (p = 0.687). The most common ADR was conjunctival hyperemia in all three groups. However, there were no serious ADRs causing ocular damage. Conclusions: Latanoprost, travoprost, and bimatoprost showed additional IOP reduction by 15.8-17.0% in DTFC-treated POAG patients.
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