정상안압녹내장에서 브리모니딘-티몰롤 다회용 점안제와 일회용 점안제의 효과 및 안정성 분석
The Efficacy and Safety of Preservative-containing and Preservative-free Brimonidine-Timolol Fixed Combination in Normal Tension Glaucoma
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 정상안압녹내장 환자에서 브리모니딘-티몰롤(brimonidine 0.2% + timolol 0.5%) 혼합 다회용 점안제와 일회용 점안제의 안압하강 효과 및 안정성에 대해 비교 분석하고자 하였다. 대상과 방법: 2017년 1월부터 2020년 2월까지 정상안안압녹내장으로 진단된 환자 중 브리모니딘-티몰롤 혼합 다회용 점안제 또는 일회용 점안제를 단독으로 투여받은 환자 51명(84안)의 의무기록을 후향적으로 분석하였다. 약제 투약 전과 후 6개월째 하루 시간대별 안압(오전 9시, 오전 11시, 오후 2시, 오후 4시)을 측정하여 두 군의 안압하강 효과와 안구 내외 부작용의 발생을 비교하였다. 결과: 혼합 다회용 제제 점안 후 점안안에서 평균 -1.95 ± 2.50 mmHg (-12.26 ± 15.87%), 일회용 제제 점안 후 평균 -1.60 ± 2.06 mmHg (-10.54 ± 13.94%)로 유의한 안압하강을 보였고, 하루 시간대별 안압은 오전 11시에 두 군에서 가장 낮게 나타났으며 모든 시간대에서 유의한 안압하강 결과를 확인하였다. 두 군 간 약제 점안 전과 후 평균 안압, 시간대별 안압에서 유의한 차이는 보이지 않았으며, 약제 중단을 유발할 만한 심각한 안구 내외 부작용은 관찰되지 않았다. 결론: 브리모니딘-티몰롤 혼합 다회용 제제와 일회용 제제는 모두 정상안압녹내장 환자에서 효과적으로 안압을 하강시키며 단기적으로 특별한 부작용이 없는 효과적인 약제로 판단된다.
Abstract
Purpose: To analyze the efficacy and safety of preservative-containing and preservative-free 0.2% brimonidine tartrate and 0.5% timolol maleate fixed combination drug in normal tension glaucoma. Methods: Fifty-one patients (84 eyes) who were diagnosed with normal tension glaucoma and with preservative-containing or preservative-free brimonidine-timolol fixed combinations alone were analyzed retrospectively from January 2017 to February 2020. Intraocular pressure (IOP) was measured four times a day (9 a.m., 11 a.m., 2 p.m., and 4 p.m.) before and at 6 months after applying eye drops. We analyzed and compared the effect of lowering IOP and the occurrence of intra or extra-ocular adverse effects. Results: A significant mean IOP reduction was shown in both groups: -1.95 ± 2.50 mmHg (-12.26 ± 15.87%) in the preservative- containing group and -1.60 ± 2.06 mmHg (-10.54 ± 13.94%) in the preservative-free group at 6 months after eyedrop instillation. The IOP was lowest in both groups at 11 a.m. There were no significant differences between the two groups in lowering IOP. Serious adverse effects causing discontinuation of the eye drops were not observed. Conclusions: Both preservative-containing and preservative-free brimonidine-timolol fixed combinations are effective in lowering IOP in normal tension glaucoma patients and are considered to be effective as eye drops without serious adverse effects.
참고문헌 (31)
- Sommer A, "Glaucoma risk factors observed in the Baltimore eye survey", Curr Opin Ophthalmol, 7, pp.93~98 (1996)
- "Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Collaborative Normal-Tension Glaucoma Study Group", Am J Ophthalmol, 126, pp.487~497 (1998)
- Heijl A, "Reduction of intraocular pressure and glaucoma progression : results from the early manifest glaucoma trial", Arch Ophthalmol, 120, pp.1268~1279 (2002)
- 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)
- Jonas JB, "Single intraocular pressure measurements and diurnal intraocular pressure profiles", Am J Ophthalmol, 139, pp.1136~1137 (2005)
- Actis AG, "Ocular surface alterations and topical antiglaucomatous therapy : a review", Open Ophthalmol J, 8, pp.67~72 (2014)
- Jaenen N, "Ocular symptoms and signs with preserved and preservative-free glaucoma medications", Eur J Ophthalmol, 17, pp.341~349 (2007)
- Baudouin C, "Preservatives in eyedrops : the good, the bad and the ugly", Prog Retin Eye Res, 29, pp.312~334 (2010)
- Malvitte L, "Measurement of inflammatory cytokines by multicytokine assay in tears of patients with glaucoma topically treated with chronic drugs", Br J Ophthalmol, 91, pp.29~32 (2007)
- Sherwood MB, "Long-term morphologic effects of antiglaucoma drugs on the conjunctiva and Tenon's capsule in glaucomatous patients", Ophthalmology, 96, pp.327~335 (1989)
- Rasmussen CA, "Benzalkonium chloride and glaucoma", J Ocul Pharmacol Ther, 30, pp.163~169 (2014)
- Leung EW, "Prevalence of ocular surface disease in glaucoma patients", J Glaucoma, 17, pp.350~355 (2008)
- Hodapp E, "Clinical decisions in glaucoma", pp.1~204 (1993), Mosby
- The Advanced Glaucoma Intervention Study Investigators, "The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration", Am J Ophthalmol, 130, pp.429~440 (2000)
- 김남주, "한국인 정상안압녹내장 환자에서 시야결손의 진행과 관련된 인자", 대한안과학회지, 44(6), pp.18~1355 (2003), 대한안과학회
- 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)
- De Saint Jean M, "Effects of benzalkonium chloride on growth and survival of Chang conjunctival cells", Invest Ophthalmol Vis Sci, 40, pp.619~630 (1999)
- Rossi GC, "Risk factors to develop ocular surface disease in treated glaucoma or ocular hypertension patients", Eur J Ophthalmol, 23, pp.296~302 (2013)
- Fechtner RD, "Prevalence of ocular surface complaints in patients with glaucoma using topical intraocular pressure-lowering medications", Cornea, 29, pp.618~621 (2010)
- Cho SW, "Effects of brimonidine 0.2%-timolol 0.5% fixed-combination therapy for glaucoma", Jpn J Ophthalmol, 54, pp.407~413 (2010)
- 박한석, "정상안압녹내장에서 브린졸라미드 1%와 티몰롤 0.5% 혼합제제의 효과", 대한안과학회지, 55(7), pp.1056~1063 (2014), 대한안과학회
- Moisseiev E, "Intraocular pressure reduction using a fixed combination of timolol maleate 0.5% and brimonidine tartrate 0.2% administered three times daily", Clin Ophthalmol, 7, pp.1269~1273 (2013)
- Kim JM, "Comparison of the intraocular pressure-lowering effect and safety of preservative-free and preservative-containing brimonidine", timolol fixed-combination ophthalmic solutions in patients with open-angle glaucoma, 2021, pp.36, 103~109
- Thygesen J, "Glaucoma therapy : preservative-free for all", Clin Ophthalmol, 12, pp.707~717 (2018)
- Goldberg I, "Clinical audit examining the impact of benzalkonium chloride-free anti-glaucoma medications on patients with symptoms of ocular surface disease", Clin Exp Ophthalmol, 43, pp.214~220 (2015)
- 연동윤, "무보존제 도졸라마이드-티몰롤 복합제제의 미사용 용기 확인을 통한 녹내장 환자의 순응도 평가", 대한안과학회지, 56(6), pp.906~910 (2015), 대한안과학회
- Sherwood MB, "Twice-daily 0.2% brimonidine-0.5% timolol fixed-combination therapy vs monotherapy with timolol or brimonidine in patients with glaucoma or ocular hypertension: a 12-month randomized trial", Arch Ophthalmol, 124, pp.1230~1238 (2006)
- Alvarado JA, "Reduced ocular allergy with fixed-combination 0.2%brimonidine-0.5% timolol", Arch Ophthalmol, 125, pp.717~ (2007)
- Jampel HD, "Apraclonidine. A one-week dose-response study", Arch Ophthalmol, 106, pp.1069~1073 (1988)
- Katz LJ, "Brimonidine tartrate 0.2% twice daily vs timolol 0.5%twice daily: 1-year results in glaucoma patients. Brimonidine Study Group", Am J Ophthalmol, 127, pp.20~26 (1999)
- Stewart WC, "Beta-blocker-induced complications and the patient with glaucoma. Newer treatments to help reduce systemic adverse events", Arch Intern Med, 158, pp.221~226 (1998)