Understanding the Treatment Paradigm and the Sequencing of Antiglaucoma Fixed-Dose Combinations in a Tertiary Center in South India

Authors

Ronnie George
Praggya Mishra
Balekudaru Shantha
Lingam Vijaya
Nitin Maksane
Neha Gurha

Publication Date

6-1-2024

Journal

Indian Journal of Ophthalmology

Abstract

PURPOSE: To analyze the medical management of primary open-angle glaucoma (POAG) and ocular hypertension (OHT) and the placement of fixed-drug combination drugs (FDC) in the treatment paradigm at a tertiary eye care center in South India.

METHODS: Retrospective study (January 2011-December 2015) of newly diagnosed POAG and OHT patients (≥18 years) with ≥5 years follow-up. Primary outcome included percentage use of different antiglaucoma drugs (at initiation) and FDCs at the first, second, and third progression (sequencing). Secondary outcomes: Percentage discontinuation for different FDCs, efficacy parameters (decrease in intraocular pressure (IOP)/visual field), adverse events, and the median number of antiglaucoma medications (AGMs) after 5 years.

RESULTS: Three hundred and seventy eyes (198 patients) were analyzed; 84% of them had POAG. Prostaglandin analogs (PGAs) were the most common (66.2%). FDCs were started in 48 eyes (12.9%), with brimonidine + timolol combination being the most common. FDC usage at subsequent modifications was 10.1%, 24.04%, and 30.0%. Beta-blockers and PGAs were the most frequently prescribed AGMs in our practice pattern, with β-blockers being the most consistent one.

CONCLUSION: This study is a fairly large study with a minimum of a 5-year follow-up of patients with POAG and OHT and gives insights into the treatment patterns, use of FDCs, and the need for multiple medications over time.

Keywords

Humans, Retrospective Studies, India, Intraocular Pressure, Male, Antihypertensive Agents, Female, Glaucoma, Open-Angle, Middle Aged, Tertiary Care Centers, Follow-Up Studies, Drug Combinations, Ocular Hypertension, Aged, Adult, Ophthalmic Solutions, Treatment Outcome, Dose-Response Relationship, Drug, Visual Fields, Drug Therapy, Combination, Adherence, antiglaucoma medications (AGMs), fixed-dose combinations (FDCs), modifications, POAG, progression

Comments

PMID: 38623708