정상안압녹내장에서 브린졸라미드/브리모니딘 혼합제제의 효과
The Efficacy of Brinzolamide 1%/Brimonidine 0.2% Fixed Combination in Normal Tension Glaucoma
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목적: 정상안압녹내장에서 brinzolamide 1%/brimonidine 0.2% 혼합제제(brinzolamide 1%/brimonidine 0.2% fixed combination, BBFC)의 안압 하강 효과 및 안정성에 대해 알아보고자 하였다. 대상과 방법: 정상안압녹내장 환자 중 brinzolamide 1%를 단독으로 사용 중인 환자 24명, brimonidine 0.2%를 단독으로 사용 중인 환자 30명, brinzolamide 1%와 brimonidine 0.2%를 함께 사용 중인 환자 16명, 그리고 정상안압녹내장을 처음으로 진단 받은 환자 17명을 대상으로 하였다. Brinzolamide 1%, brimonidine 0.2%를 단독으로 사용 중인 환자와 brinzolamide 1%와 brimonidine 0.2%를 함께 사용 중인 환자는 BBFC로 약제를 변경하였으며 처음 정상안압녹내장을 진단 받은 환자는 BBFC로 처음 점안을 시작하였다. BBFC 치료 전, 치료 후 1주, 4주, 8주, 12주, 그리고 24주째 외래에 방문하였으며 치료 전후 안압 하강 효과를 비교 분석하였고 약제부작용에 대해 조사하였다. 결과: Brinzolamide 1% 단독 제제에서 BBFC로 녹내장 약제를 변경한 환자의 약제 변경 전과 후의 평균 안압은 각각 13.5 ± 1.6 mmHg, 12.1 ± 1.5 mmHg였다. Brimonidine 0.2% 단독 제제에서 BBFC로 변경한 경우의 변경 전과 후의 평균 안압은 각각 14.2 ± 1.3 mmHg, 11.7 ± 1.5 mmHg였다. Brinzolamide 1%와 brimonidine 0.2%를 함께 사용 중인 환자에서 BBFC로 변경한 경우 약제 변경 전과 후의 평균 안압은 각각 11.9 ± 2.1 mmHg, 12.0 ± 1.1 mmHg로 통계적인 유의성은 없었다. 정상안압녹내장을 처음 진단 받고 BBFC를 사용한 경우 치료 후 평균 안압은 10.7 ± 2.1 mmHg, 안압 감소율은 35.5%였다. 약제를 중단할 만한 심각한 부작용은 나타나지 않았다. 결론: BBFC는 정상안압녹내장 환자에서 안전하고 효과적으로 안압을 하강시킨다.
Abstract
Purpose: To evaluate the efficacy and safety of brinzolamide 1%/brimonidine 0.2% fixed combination (BBFC) in normal tension glaucoma (NTG) patients. Methods: This prospective study included patients treated with brinzolamide 1% monotherapy, brimonidine 0.2% monotherapy or brinzolamide 1% and brimonidine 0.2% concomitant therapy, as well as newly diagnosed NTG patients. The enrolled patients who used brinzolamide 1% or brimonidine 0.2% switched to BBFC and newly diagnosed NTG patients were treated with BBFC. The patients receiving brinzolamide 1% or brimonidine 0.2% monotherapy or brinzolamide 1% and brimonidine 0.2% concomitant therapy switched antiglaucoma drugs to BBFC. Newly diagnosed NTG patients used BBFC as the first therapy. The study consisted of 1 screening/baseline visit and 3 follow-up visits conducted after 1, 4, 8, 12 and 24 weeks of treatment. Intraocular pressure (IOP), mean deviation value and adverse drug reactions were evaluated before treatment and after treatment with BBFC. Results: The mean IOP in the brinzolamide 1% monotherapy group was 13.5 ± 1.6 mm Hg and the mean IOP after switched from brinzolamide 1% monotherapy to BBFC was 12.1 ± 1.5 mm Hg. The mean IOP in the brimonidine 0.2% monotherapy group was 14.2 ± 1.3 mm Hg and the mean IOP after switched from brimonidine 0.2% monotherapy to BBFC was 11.7 ± 1.5 mm Hg. The mean IOP was 11.9 ± 2.1 mm Hg in the brinzolamide 1% and brimonidine 0.2% concomitant therapy group and the mean IOP after switched from brinzolamide 1% and brimonidine 0.2% concomitant therapy to BBFC was 12.0 ± 1.1 mm Hg. The mean IOP and reduction rate were 10.7 ± 2.1 mm Hg and 35.5%, respectively,in the newly diagnosed NTG patients treated with BBFC. There was no serious adverse drug reaction causing ocular damage. Conclusions: BBFC provides a significant IOP reduction and is a safe antiglaucoma medication for NTG patients.
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