A randomized, 36-month, post-marketing efficacy and tolerability study in Sweden and Finland of latanoprost versus non-prostaglandin therapy in patients with glaucoma or ocular hypertension.
OBJECTIVE
To compare the effect of time on therapy, efficacy, tolerability and resource utilization of latanoprost or non-prostaglandin analogues (non-PGs) in patients who required a change in intraocular pressure (IOP)-lowering monotherapy.


METHODS
This open-label, multicentre study (Sweden, 19 sites; Finland, seven sites) included adults with glaucoma or ocular hypertension with mean diurnal IOP > or = 21 mmHg on ocular hypotensive monotherapy. Patients were randomized to latanoprost monotherapy or non-PG therapy (commercially available therapy other than a PG) and followed for 36 months. End-points included: time to treatment failure (baseline to visit with a change in/addition to treatment); diurnal IOP (mean of 08.00, 12.00 and 16:00 hr measurements) at months 6, 12, 24 and 36; tolerability; and resource utilization, where analyses used Swedish and Finnish 2006 unit costs.


RESULTS
Three hundred and twenty-six patients received >or = 1 dose of latanoprost (n = 162) or non-PGs (n = 164). Median time to treatment failure was longer for latanoprost (36 months) than for non-PGs (12 months; p < 0.001); 51% and 24% of patients remained on randomized therapy after 36 months, respectively (p < 0.001). Decreases in mean diurnal IOP from baseline were significantly greater for latanoprost than for non-PGs at months 6 and 12 (p < 0.01). No serious adverse events were judged to be treatment-related. Mean total 36-month direct costs were similar in patients initiated with latanoprost and non-PGs.


CONCLUSIONS
Patients who failed previous monotherapy remained on therapy longer when switched to latanoprost. Latanoprost's IOP-reducing effect and tolerability were sustained over the long term. Resource utilization and costs were generally similar in those initiating latanoprost or non-PG therapy.
Friström
Björn
B
University Hospital, Linköping, Sweden. bjorn.fristrom@lio.se
Uusitalo
Hannu
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D005387:Finland; D005901:Glaucoma / Q000188:drug therapy*; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D053208:Kaplan-Meier Estimate; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy*; D011358:Product Surveillance, Postmarketing; D011453:Prostaglandins / Q000009:adverse effects / Q000627:therapeutic use; D011461:Prostaglandins F, Synthetic / Q000009:adverse effects* / Q000191:economics / Q000627:therapeutic use*; D019233:Retreatment; D013548:Sweden; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D011453:Prostaglandins; D011461:Prostaglandins F, Synthetic; D000077338:Latanoprost