PRESERVED FIXED COMBINATION: A CONFIDENT STEP TOWARDS EFFECTIVE TREATMENT OF PRIMARY OPEN-ANGLE GLAUCOMA

PURPOSE: To study the efficacy, safety and tolerability of preservative-free fixed combination in the treatment of patients with open-angle glaucoma.

METHODS: The study included 147 patients (289 eyes) divided into 4 groups: Group I included 35 people (69 eyes) who previously received Duotrav (travoprost 0.004% solution, timolol maleate 0.5%, “Novartis”), Group II comprised 38 people (74 eyes) with previous instillations of nonselectiveblockers (timolol maleate 0.5% solution), Group III consisted of 31 people (60 eyes) with prior hypotensive therapy with Taflotan (tafluprost 0.0015% solution, “Santen”) and Group IV — 43 people (86 eyes) who had not previously received any hypotensive therapy. All patients were transferred to a standard mode of Tapticom instillation (0.0015% solution of tafluprost in fixed combination with 0.5% timolol maleate). All patients underwent IOP monitoring, automated computer perimetry, biomicroscopy and drug tolerability assessment according to subjective complaints of the patient.

RESULTS and СONCLUSION: A decrease in IOP level by an average of 37.5% was noted among POAG patients after they changed their current hypotensive drug to a fixed preservative-free combination drug Tapticom (0.0015% solution of tafluprost with 0.5% timolol maleate). Target IOP was reached in 83% of patients, using Tapticom as the starting therapy. In patients who previously instilled betablockers and analogues of prostaglandins, the alteration in hypotensive scheme allowed an additional decrease in intraocular pressure from the initial 22-25%, achieving target IOP in 86-91% of cases. Functional perimetry parameters stabilization was achieved, an increase in the total photosensitivity of the central and peripheral fields was observed, which was expressed in a significant increase in the perimetrical indices of MD and PSD in all study groups by the 3rd month of treatment.

1. Kapetanakas V.V., Chan M.P., Foster P.J. et al. Global variations and time trends in the prevalence of primary open angle glaucoma (POAG): a systematic review and meta-analysis. Br J Ophthalmol 2016; 100(1):86-93.

2. Kiseleva O.A., Robustova O.V., Bessmertny A.M., Zakharova E.K., Avdeev R.V. Prevalence of primary glaucoma in representatives of different races and ethnic groups in Russia and CIS. Ophthalmology 2013; 10(4):11-15. (In Russ.).

3. Marquis R.E., Whitson J.T. Management of glaucoma: focus on pharmacological therapy. Drugs Aging 2005; 22:1-21.

4. European Glaucoma Society. Terminology and guidelines for glaucoma. 4. Savona: Publi Comm; 2014.

5. Denis P., Lafuma A., Berdeaux G. Medical outcomes of glaucoma therapy from a nationwide representative survey. Clin Drug Investig 2004; 24(6):343-352.

6. Konstas A.G., Holl G. Preservative-free tafluprost/timolol fixed combination: a new opportunity in the treatment of glaucoma. Expert Opin Pharmacother 2016; 17(9):1271-1283.

7. Hoy S.M. Tafluprost/Timolol: A review in open-angle glaucoma or ocular hypertension. Drugs 2015; 75(15):1807-1813.