title: Patient persistence with first-line antiglaucomatous monotherapy.
abstract: OBJECTIVE
  To identify the extent of persistence (period of time of continuous therapy with the drug prescribed) of glaucoma patients treated with prostaglandins (latanoprost, bimatoprost, or travoprost), or beta-blocker (timolol) monotherapy.
  
  
  METHODS
  An observational retrospective study of a 24-month follow-up in 191 patients (from four centers) was done to identify the time elapsed until patients discontinued their antiglaucomatous treatment. The relevant information was extracted from patients' medical charts. A descriptive analysis, a Kaplan-Meier survival analysis, and a Cox regression model were used to determine which drug was associated with greater patient persistence and to detect variables significantly influencing persistence.
  
  
  RESULTS
  Descriptive analysis and survival curves showed that after 24 months, latanoprost was associated with a higher persistence in glaucoma treatment than the alternative agents: 81.6% versus 22.9% for bimatoprost, 65.4% for travoprost, and 60.5% for timolol (P < 0.0001). Persistence was significantly influenced by the antiglaucoma agent used as monotherapy (with a six-fold higher risk of treatment discontinuation during the follow-up period due to receiving bimatoprost instead of latanoprost; P < 0.0001) and patient age (P = 0.001). Even though comorbidities could not be directly related to persistence, their occurrence was related to patient age. The main reasons for treatment discontinuation were lack of efficacy, development of intolerance and/or adverse events, which were significant in the bimatoprost group, 28.6% (P < 0.001) and 48.6% (P < 0.001), respectively.
  
  
  CONCLUSIONS
  Latanoprost shows higher patient persistence compared with travoprost, bimatoprost, and timolol in routine clinical practice, and could lead to better control of intraocular pressure and lower associated economic costs.
authors.affiliation: Ophthalmology Department, Fundación Hospital Alcorcón, Madrid, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Arias
authors.forename: Konrad
authors.initials: K
authors.lastname: Schargel
authors.forename: Fernando
authors.initials: F
authors.lastname: Ussa
authors.forename: Maria I
authors.initials: MI
authors.lastname: Canut
authors.forename: Amelia Y Belén
authors.initials: AY
authors.lastname: Robles
authors.forename: Belén Martí
authors.initials: BM
authors.lastname: Sánchez
references.citation: Indian J Ophthalmol. 2003 Jun;51(2):123-8
references.pmid: 12831141
references.citation: Can J Ophthalmol. 2005 Apr;40(2):161-9
references.pmid: 16049529
references.citation: Clin Ther. 2003 Apr;25(4):1172-85
references.pmid: 12809964
references.citation: Eur J Ophthalmol. 2003 Jul;13 Suppl 4:S53-60
references.pmid: 12948053
references.citation: Am J Ophthalmol. 2004 Jan;137(1 Suppl):S13-6
references.pmid: 14697910
references.citation: Am J Ophthalmol. 2004 Jan;137(1 Suppl):S3-12
references.pmid: 14697909
references.citation: Arch Ophthalmol. 2002 Jun;120(6):701-13; discussion 829-30
references.pmid: 12049574
references.citation: Am J Public Health. 1993 May;83(5):711-6
references.pmid: 8484454
references.citation: Arch Ophthalmol. 2002 Oct;120(10):1268-79
references.pmid: 12365904
references.citation: Curr Opin Ophthalmol. 2003 Apr;14(2):86-90
references.pmid: 12698048
references.citation: Eur J Ophthalmol. 2003 Jul;13 Suppl 4:S21-9
references.pmid: 12948050
references.citation: Community Eye Health. 2008 Sep;21(67):37-9
references.pmid: 19030126
references.citation: Am J Manag Care. 2002 Aug;8(10 Suppl):S262-70
references.pmid: 12188169
references.citation: J Ocul Pharmacol Ther. 2009 Apr;25(2):145-52
references.pmid: 19284321
references.citation: Am J Manag Care. 2002 Aug;8(10 Suppl):S271-7
references.pmid: 12188170
references.citation: Am J Ophthalmol. 2000 Oct;130(4):429-40
references.pmid: 11024415
references.citation: Am J Ophthalmol. 2003 May;135(5):688-703
references.pmid: 12719078
references.citation: Eur J Ophthalmol. 2003 Jul;13 Suppl 4:S44-52
references.pmid: 12948052
references.citation: Am J Manag Care. 2002 Aug;8(10 Suppl):S255-61
references.pmid: 12188168
references.citation: J Ocul Pharmacol Ther. 2004 Oct;20(5):383-92
references.pmid: 15650513
references.citation: J Ayub Med Coll Abbottabad. 2004 Jan-Mar;16(1):50-3
references.pmid: 15125183
references.citation: Am J Manag Care. 2002 Aug;8(10 Suppl):S249-54
references.pmid: 12188167
references.citation: Surv Ophthalmol. 2004 Mar;49 Suppl 1:S45-52
references.pmid: 15016561
references.citation: Curr Opin Ophthalmol. 2005 Apr;16(2):114-21
references.pmid: 15744142
references.citation: J Glaucoma. 2003 Dec;12(6):463-5
references.pmid: 14646679