녹내장에서 브리모니딘/티몰롤 복합제제와 0.15% 브리모니딘 사용 시 알레르기 발생률의 비교
Comparison of Allergy Prevalence between Brimonidine/Timolol Fixed Combination and 0.15% Brimonidine in Glaucoma Patients
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목적: 한국 녹내장 환자에서 0.2% brimonidine/0.5% timolol 복합제제(0.2% brimonidine/0.5% timolol fixed combination, BTFC)와 0.15% brimonidine의 알레르기 발생과 임상양상을 비교하고자 하였다. 대상과 방법: 녹내장으로 진단받은 환자 중 BTFC를 사용한 환자 196명, 0.15% brimonidine을 사용한 환자 234명을 대상으로 의무기록을 후향적으로 분석하였다. 환자의 성별, 나이, 녹내장 형태, 점안액 치료 시작 후 경과관찰 기간, 알레르기 발생 유무, 알레르기 발생 시기 및 알레르기의 임상특징을 조사하여 비교 분석하였다. 결과: 안구 알레르기 발생률은 BTFC 치료군에서 10.14%, 0.15% brimonidine 치료군에서 22.02%로 BTFC를 사용한 환자에서 알레르기가 발생할 위험이 약 0.4배 더 낮았으며 통계적으로 유의하였다(hazard ratio = 2.5, p=0.009). 알레르기 발생 시기는 BTFC는 평균 20.5개월(범위: 1.7-51.1개월), 0.15% brimonidine은 평균 7.7개월(범위: 0.4-50.8개월)이었다. BTFC 치료군에서 알레르기 반응의 50%가 15개월 내에 발생했지만 0.15% brimonidine 치료군의 경우 초기 5개월 이내에 나타났다. Brimonidine에 의한 알레르기 임상양상은 결막여포와 결막유두 두 가지 형태가 관찰되었으며 형태에 따른 발생 비율에는 유의한 차이는 없었다(p=0.566). 결론: 한국 녹내장 환자에서 BTFC는 0.15% brimonidine보다 안구 알레르기가 발생률이 낮고 발생 시기도 늦다. 본 결과는 약제사용 관련 환자교육 및 점안 순응도 향상에 도움을 줄 것으로 기대된다.
Abstract
Purpose: To compare the allergy prevalence and clinical manifestations of 0.2% brimonidine/0.5% timolol fixed combination (BTFC) and 0.15% brimonidine in Korean patients with glaucoma. Methods: We retrospectively analyzed the medical records of 196 glaucoma patients treated with BTFC and 234 glaucoma patients treated with 0.15% brimonidine. We compared sex, age, type of glaucoma, treatment period, allergy history, onset time of ocular allergy and clinical characteristics of allergy in the two groups. Results: Ocular allergy percentages 10.14% in the BTFC group and 22.02% in the 0.15% brimonidine group, and the risk of allergy was approximately 0.4 times lower in patients using BTFC (hazard ratio = 2.5, p = 0.009). The BTFC group developed ocular allergy at a mean of 20.5 months (range: 1.7–51.1 months), and the 0.15% brimonidine group developed ocular allergy at a mean of 7.7 months (range: 0.4–50.8 months). In the BTFC group, 50% of the ocular allergy occurred within 15 months, and within 5 months in the 0.15% brimonidine group. Clinical characteristics of brimonidine allergy involved two types of conjunctival follicles and conjunctival papillae, but there were no significant differences in incidence according to allergy type (p = 0.566). Conclusions: The prevalence of ocular allergy in the BTFC group was lower than that in the 0.15% brimonidine group in Korean patients with glaucoma. The results of this study are expected to be useful for patient education and compliance improvement using brimonidine.
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