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Tafluprost: The First Preservative-Free to Treat Open-Angle and

Article in Annals of Pharmacotherapy · October 2012 DOI: 10.1345/aph.1R229 · Source: PubMed

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New Drug Approvals

Tafluprost: The First Preservative-Free Prostaglandin to Treat Open-Angle Glaucoma and Ocular Hypertension

Cory Swymer and Michael W Neville

afluprost 0.0015% ophthalmic solu- tion (Zioptan) was approved by the T OBJECTIVE: To review the pharmacology, , clinical trial data, Food and Drug Administration on Febru- efficacy data, and adverse effect incidence of tafluprost. ary 10, 2012, for the treatment of elevated DATA SOURCES: A literature search was completed using PubMed, Web of (IOP) in patients with Science, and Google Scholar. Tafluprost was the primary search term. Articles open-angle glaucoma, in addition to ocular published between January 2008 and April 2012 were included in this review. hypertension.1 Although it has been used Additional limits placed on the searches were “human” and “English.” Citations in in other countries since 2008, tafluprost is which tafluprost appeared in the title were 36, 29, and more than 300 in PubMed, Web of Science, and Google Scholar, respectively. the first preservative-free prostaglandin STUDY SELECTION AND DATA EXTRACTION: Three clinical trials were included in analogue commercially available in the this review. One trial enrolled more than 500 subjects in a randomized fashion. US. Another also enrolled more than 500 subjects, although the study design was not randomized. The third trial evaluated the effects of tafluprost on subjects who had Pharmacology recently discontinued use of , another prostaglandin that is approved to treat glaucoma and ocular hypertension. The duration of all 3 trials was 12 weeks. Open-angle glaucoma is an ocular dis- DATA SYNTHESIS: Tafluprost 0.0015% is the first topical prostaglandin approved order characterized by changes in the optic by the Food and Drug Administration for treatment of open-angle glaucoma and nerve head that leads to the loss of visual ocular hypertension that does not contain the widely used preservative, field.2 Increased ocular pressure is one of benzalkonium chloride (BAK). Although some controversy surrounds the long- term safety of exposure to BAK, clinical trial data are inconclusive. Tafluprost, like many contributing factors of glaucoma de- other prostaglandin analogues, exerts its effects on prostaglandin F receptors to velopment. Treatment focuses on the use reduce intraocular pressure (IOP). Results from 1 trial demonstrated significant of multiple agents, including α-2-adren- reductions in IOP when monotherapy was switched to tafluprost monotherapy. ergic , β-blockers, car- Reductions in IOP with tafluprost use were compared with those seen with use of bonic anhydrase inhibitors, and prosta- and latanoprost in 2 trials, and noninferiority was observed. Significant reductions in tear osmolarity were noted in subjects who changed from glandin analogues. Varying mechanisms latanoprost, another , to tafluprost therapy. Conjunctival of action offered by these classes lower hyperemia is the most common adverse effect seen in patients receiving drugs IOP and subsequent complications asso- from this class. Many have also reported stinging, ocular pruritus, increased ciated with glaucoma. Prostaglandin darkening or growth of eyelashes, and darkening of eyelids, as well as analogues are a first-line therapy option irreversible brown pigmentation of the . in treating elevated intraocular pressure CONCLUSIONS: Clinical trial data suggest that tafluprost is as efficacious as other because of their known efficacy and agents used in the management of ocular hypertension and glaucoma. Its use may be especially advantageous in people with , sensitivities to minimal adverse effects.3 Tafluprost is preservatives, or dry or sensitive eyes. thought to stimulate the selective prosta- KEY WORDS: glaucoma, intraocular pressure, ocular hypertension, preservative- glandin F receptor (FP), which results in free, prostaglandin, tafluprost, Zioptan. increased uveoscleral and trabecular out- Ann Pharmacother 2012;46:1506-10. flow of aqueous humor and subsequent Published Online, 23 Oct 2012, theannals.com, doi: 10.1345/aph.1R229

Author information provided at end of text.

1506 I The Annals of Pharmacotherapy I 2012 November, Volume 46 theannals.com Downloaded from aop.sagepub.com by guest on October 11, 2013 decreased intraocular pressure.4 Although tafluprost offers Pharmacokinetics no significant pharmacologic advantage over its counter- parts within the prostaglandin class, it is the first topical Tafluprost is an ester that is hydrolyzed into the 4 prostaglandin available in a preservative-free formulation. biologically active metabolite, tafluprost acid, in the eye. Preservatives are contained in most ophthalmic prepara- The acid compound is further metabolized via β-oxidation tions and prolong the shelf life of many by preventing and phase II conjugation. Plasma concentrations of biodegradation and maintaining potency.5 Although several tafluprost acid peak about 10 minutes after instillation of 1 are available, benzalkonium chloride (BAK), which has drop of 0.0015% solution. Plasma tafluprost acid concen- surfactant, bactericidal, and bacteriostatic properties, is the trations are below detectable levels (10 pg/mL) following most commonly used preservative in ophthalmic prepara- topical administration. Pharmacokinetic comparisons4,10-12 tions.6 However, there have been some reports that BAK is between tafluprost and other prostaglandin preparations are associated with potentially harmful effects on the tear film summarized in Table 1. of the eye.7 BAK also appears to increase tear osmolarity.8 Investigators often assess tear film osmolarity as a means Clinical Trials of evaluating eye dryness.5 Normal values typically range from 290 to 300 mOsm/L; as osmolarity rises above this Hommer and colleagues enrolled 544 subjects in an 13 range, the odds of eye irritation increase. As a result, pa- open-label, multicenter, observational study. Subjects had tients report increased discomfort and dry eyes.8 Pellinen a previous diagnosis of ocular hypertension or glaucoma. and colleagues7 determined that higher concentrations of They required add-on therapy, change of , or BAK increase the incidence of cytotoxic effects. A positive were naïve to medical treatment. The mean duration of correlation also appears to exist between the amount of glaucoma was 6.5 years (range <1-35) at baseline. Most BAK contained in an ophthalmic preparation and the inci- participants (n = 360, 66.2%) had received monotherapy dence of dry eye and discomfort.9 Tressler and colleagues6 with prostaglandin analogues (n = 124) or β-blockers (n = examined the literature to determine whether BAK is asso- 129) prior to the study, and 25.6% had used a non-fixed or ciated with adverse sequelae when used long term in indi- fixed combination prior to the change of medication. At viduals with glaucoma. They summarized and examined their discretion during the trial, research ophthalmologists published data from in vitro, ex vivo, and in vivo studies changed therapy to or added therapy with tafluprost from 1970 to July 2009. The investigators noted that pre- 0.0015% once daily and monitored the subjects for 12 clinical evidence suggests that exposure to high concentra- weeks. tions of BAK for extended periods increases adverse ef- Data on subjective symptoms, tear-film break-up time fects. However, clinical evidence is more inconclusive; (TBUT), and baseline tear fluid amount in a subgroup of findings are not consistent from study to study. Studies that participants were collected. Satisfaction data were also col- have evaluated the long-term safety of BAK have not lected. IOP measurements were completed prior to treat- demonstrated a clear correlation with BAK concentrations ment and evaluated at 4-6 weeks and at 12 weeks after and ocular surface adverse events. Additionally, the active changing therapy to or adding tafluprost. Five hundred medication may cause ocular surface irritation, confound- forty-four subjects (1088 eyes) were included in the evalu- ing findings. Finally, many people diagnosed with glauco- ation. Diagnoses included open-angle glaucoma (76.6%), ma experience dry eyes and some within this group may ocular hypertension (10.9%), normal tension glaucoma be especially susceptible to ocular surface changes caused (6.2%), pseudo exfoliation glaucoma (3.0%), and other by BAK, the active medication, or the combination. (3.3%).13

Table 1. Pharmacokinetics of Commonly Used Prostaglandin Analogues3,10-12

Parameter Latanoprost Tafluprost

Maximum concentration Within 10 minutes 2 hours Within 30 minutes Within 10 minutes Distribution Plasma (88% bound) Aqueous humor (first 4 hours); plasma Not reported Not reported (1 hour after local administration) Metabolism N-deethylation and β-oxidation in Esterases in β-oxidation and phase II glucuronidation conjugation Elimination Renal, 67% Renal Levels undetectable in 1 hour Levels undetectable in 30 minutes Reduction in IOP 7-8 mm Hg 6-8 mm Hg 7-8 mm Hg 5-8 mm Hg

IOP = intraocular pressure. theannals.com The Annals of Pharmacotherapy I 2012 November, Volume 46 I 1507 C Swymer and MW Neville were changed to tafluprost from other ther- hypotensive agents were discontinued at the start of the apies in 60.7% of subjects because of poor efficacy, while study and mean IOP values were required to be within the clinical signs and subjective symptoms resulted in a medi- initial baseline range of 23 mm Hg or more and 36 mm Hg cation change or the addition of tafluprost to existing regi- or less in at least 1 eye.14 mens in 30.7% of subjects. Prior to having therapy switched A total of 618 subjects (timolol, 312; tafluprost, 306) to tafluprost, 66% had received monotherapy with either ß- completed the trial with a similar dropout rate between blocker or prostaglandin therapy while 26% had used a groups. Reductions in IOP were noted in both groups by fixed or non-fixed combination.13 week 2 and tafluprost was noninferior to timolol with re- Mean IOP measurements in all subjects at 4-6 weeks spect to IOP reduction over the course of the study. and at 12 weeks were statistically significantly lower than Tafluprost adverse event rates were similar to those seen in baseline measurements and decreased by 19.1% and 12.1%, the timolol group, 22.8% and 22.6%, respectively. Howev- respectively. Tafluprost decreased IOP to 18 mm Hg or less er, conjunctival hyperemia occurred at a higher rate in the in 79.5%, 16 mm Hg or less in 63.8%, and 14 mm Hg or tafluprost group than in the timolol group (4.4% vs 1.2%, less for 47.3 % of all eyes.13 respectively; p = 0.016). Investigators concluded that When lack of efficacy prompted the switch from tafluprost may be an alternative in patients with allergies to monotherapy with another agent to tafluprost monothera- preservatives or those with adverse events related to py, IOP-lowering effect was significantly decreased (p < preservative-containing hypotensive agents.14 0.001). When tolerability was the driver to change thera- Januleviãienò and colleagues5 evaluated the effects on pies, smaller differences were observed.13 tear osmolarity, IOP, and tolerability in subjects whose Patients and researchers rated tolerability of treatments; treatment was switched from latanoprost to tafluprost in a 94.8% of patients and 69.2% of physicians were very satis- prospective, observer-masked study over 12 weeks. Thirty fied or satisfied with tafluprost at the 12-week visit. TBUT subjects (60 eyes), 26 women and 4 men, with a mean age and tear fluid amounts in patients with tafluprost added or of 64.2 years, participated. Subjects included had a diagno- those who changed to tafluprost were evaluated in 32 and sis of open-angle glaucoma in at least 1 eye, mild dry eye 37 subjects, respectively. Both values increased significant- (according to the Ocular Surface Disease Index [OSDI]), ly from baseline (p < 0.005). Forty-seven participants and IOP controlled with latanoprost 50 µg/mL for no less (8.6%) discontinued treatment during the 12-week trial. than 1 continuous month prior to the study. Termination reasons included lack of efficacy (3.1%), local All subjects were required to discontinue latanoprost intolerance (2.6%), other reasons (1.1%), systemic adverse treatment at baseline, and tear film osmolarity level, the effects (0.7%), difficulty handling single-dose containers primary outcome measure, was evaluated at weeks 2, 6, (0.7%), and (0.4%). Investigators noted that and 12 of tafluprost therapy. Secondary outcomes assessed tafluprost 0.0015% was effective, associated with fewer included TBUT, IOP-OSDI, and Ocular Surface Symp- adverse effects, and well tolerated in patients with ocular toms in Glaucoma Scale (OSSG) at baseline and at the hypertension and glaucoma. They expect its benefits to be conclusion of the study. Baseline characteristics were simi- most realized in those with subjective ocular symptoms, lar between right and left eyes at baseline.5 dry or sensitive eyes, or in those not responding well to Tear osmolarity decreased in 62% of eyes after 2 weeks other monotherapies.13 of treatment, 77% after 6 weeks, and 82% after 12 weeks A randomized, double-masked, multicenter clinical trial (p < 0.005). Mean osmolarity ± SD was significantly re- by Chabi and colleagues14 compared the efficacy and safe- duced from 315.7 mOsm/L at baseline to 308 ± 14.4 ty of preservative-free tafluprost 0.0015% with preserva- mOsm/L (95% CI 277 to 338; p = 0.002 vs baseline), 301.7 tive-free timolol 0.5% in subjects with open-angle glauco- ± 14.5 mOsm/L (95% CI 275 to 340; p < 0.001 vs baseline), ma or ocular hypertension. The primary end point was and 302 ± 9.9 mOsm/L (95% CI 283 to 327; p < 0.001) at mean IOP change from baseline at 9 time points over 12 weeks 2, 6, and 12, respectively. TBUT scores increased sig- weeks. A noninferiority analysis was used to compare nificantly, from 3.7 ± 1.1 seconds at baseline to 4.1 ± 1.0 sec- treatment groups. onds, 5.2 ± 1.5 seconds, and 6.5 ± 1.5 seconds after weeks 2, Tolerability and safety were assessed by counts and re- 6, and 12, respectively. The mean (SD) IOP was 16.4 (3.0) view of adverse events within 14 days after the last dose or mm Hg at baseline and values were not statistically different discontinuation. Investigators enrolled men and women by weeks 2, 6, or 12. Subjective complaint data assessed via aged 18 years or older with a diagnosis of primary open- the OSSG and OSDI instruments revealed that the percent- angle glaucoma, capsular glaucoma/pseudo exfoliation, age of subjects who felt dry eye symptoms at baseline was ocular hypertension, or pigmentary glaucoma. Subjects’ reduced from 40% to 26.7% and that the percentage of sub- IOP could either be stable with ocular hypotensive medica- jects who had mild eye complaints at baseline was reduced tion for 30 days or patients could be treatment naïve and from 53.3% to 26.7% by study completion. Investigators have a mean IOP of 36 mm Hg or less in both eyes. Ocular concluded that tafluprost can improve subjective symptoms,

1508 I The Annals of Pharmacotherapy I 2012 November, Volume 46 theannals.com Tafluprost for Open-Angle Glaucoma and Ocular Hypertension improve TBUT, maintain IOP control, and normalize tear os- Summary molarity. The agent may be especially useful in glaucoma pa- tients with dry and sensitive eyes.5 Tafluprost is a preservative-free, once-daily topical prosta- glandin analogue approved to decrease IOP in open-angle glaucoma and ocular hypertension. While it does not appear Dosage Recommendations to offer a distinct therapeutic advantage compared with others Tafluprost is indicated for patients with elevated IOP. in its class, its improved adverse effect profile makes it a vi- Patients should instill 1 drop into the conjunctival sac of able alternative in patients with sensitivities to preservatives. the affected eye(s) once daily.4 Storage and stability data are available at Merck’s web- Cory Swymer PharmD, at time of writing, PharmD student, Col- lege of Pharmacy, University of Georgia, Athens; now, Director of site.4 Tafluprost is available in counts of 30 or 90 single- Pharmacy, Putnam General Hospital, Eatonton, GA use containers. The containers have 0.3 mL of solution or Michael W Neville PharmD BCPS FASHP, Clinical Associate Pro- 0.0045 mg of tafluprost. Unopened cartons and foil pouch- fessor, College of Pharmacy, University of Georgia Correspondence: Dr. Neville, [email protected] es should be refrigerated at 2-8 ˚C. After the foil pouch has Reprints/Online Access: www.theannals.com/cgi/reprint/aph.1R229 been opened, the single-use containers may be stored in the Conflict of interest: Authors reported none opened pouch for up to 28 days at room temperature 20- 25 ˚C. References Adverse Effects 1. FDA news release: FDA approves Zioptan to treat elevated eye pressure. www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm29196 The most common adverse effect associated with the 6.htm (accessed 2012 Feb 21). 2. Fiscella R, Lesar T, Edward D. Glaucoma. In: Dipiro J, Talbert R, Yee G, use of tafluprost and other prostaglandin analogues is con- Matzke G, Wells B, Posey LM, eds. Pharmacotherapy: a pathophysio- 2,4 junctival hyperemia. Other ocular adverse reactions in- logic approach. 7th ed. New York: McGraw Hill, 2008:1551-64. clude ocular stinging, ocular pruritus, cataract, dry eye, oc- 3. Aptel F, Denis P. Balancing efficacy and tolerability of prostaglandin ular pain, eyelash darkening, growth of eyelashes, and analogues and prostaglandin-timolol fixed combinations in primary open-angle glaucoma. Curr Med Res Opin 2011;27:1949-58. 4 . 4. Prescribing information. Zioptan (tafluprost). Whitehouse Station, NJ: However, the package insert4 lists no contraindications Merck & Co. www.merck.com/product/usa/pi_circulars/z/zioptan/ for the use of tafluprost. It has been reported to cause po- zioptan_pi.pdf (accessed 2012 Feb 23). tentially permanent changes in pigments of the iris. It 5. Januleviãienò I, Derkaã I, Grybauskiene L, Paulauskaitò R, Gromnick- aite R, Kuzmienò L. Effects of preservative-free tafluprost on tear film has also been associated with gradually reversible osmolarity, tolerability, and intraocular pressure in previously treated pa- changes in eyelashes; these may include changes in tients with open-angle glaucoma. Clin Ophthalmol (Auckland, NZ) number, length, color, or thickness. Patients experienc- 2012;6:103. 6. Tressler CS, Beatty R, Lemp MA. Preservative use in topical glaucoma ing active intraocular should avoid medications. Ocul Surf 2011;9:140-58. tafluprost use, which will likely exacerbate the condi- 7. Pellinen P, Huhtala A, Tolonen A, Lokkila J, Mäenpää J, Uusitalo H. The tion. Caution should also be exercised in aphakic pa- cytotoxic effects of preserved and preservative-free prostaglandin analogs tients, as macular has been reported during on human corneal and conjunctival epithelium in vitro and the distribu- tion of benzalkonium chloride homologs in ocular surface tissues in vivo. 4 prostaglandin analogue use. Tafluprost is classified as a Curr Eye Res 2012;37:1-10. pregnancy category C medication, so its therapeutic ben- 8. Noecker R. Ophthalmic preservatives: considerations for long-term use efits to the mother should be weighed against the poten- in patients with dry eye or glaucoma. Rev Ophthalmol 2001;8:73-9. tial risk to the . 9. Hommer A. A review of preserved and preservative-free prostaglandin analogues for the treatment of open-angle glaucoma and ocular hyperten- sion. Drugs of Today (Barcelona, Spain: 1998) 2010;46:409. Formulary Considerations 10. Prescribing information. Lumigan (bimatoprost). Irvine, CA: Allergan. www.allergan.com/assets/pdf/Lumigan_pi.pdf (accessed 2012 Mar 16). Clinical trial data do not suggest clinical superiority of 11. Prescribing Information. Xalatan (latanoprost). Woodstock, IL: . tafluprost over other with respect to effica- http:// Labeling.pfizer.com/ShowLabeling.aspx?id = 613 (accessed 2012 Mar 16). cy. Tafluprost recipients may still experience ocular ad- 12. Prescribing information. Travatan Z (travoprost). Fort Worth, TX: Alcon verse events such as eye irritation, ocular pain, eyelash Laboratories. http://ecatalog.alcon.com/pi/TravatanZ_US_en.pdf (accessed changes, and blurred vision. However, data seem to sug- 2012 Mar 16). 13. Hommer A, Mohammed Ramez O, Burchert M, Kimmich F. IOP-lower- gest a better adverse effect profile for tafluprost compared ing efficacy and tolerability of preservative-free tafluprost 0.0015% with other prostaglandins. The introduction of tafluprost among patients with ocular hypertension or glaucoma. Curr Med Res onto the market offers an alternative to patients unable to Opin 2010;26:1905-13. tolerate preservative-containing products. Long-term data 14. Chabi A, Varma R, Tsai JC, et al. Randomized clinical trial of the effica- cy and safety of preservative-free tafluprost and timolol in patients with that compare out-of-pocket costs of tafluprost with other open-angle glaucoma or ocular hypertension. Am J Ophthalmol 2012; agents are currently unavailable. 153:1187-96. theannals.com The Annals of Pharmacotherapy I 2012 November, Volume 46 I 1509 C Swymer and MW Neville

EXTRACTO RÉSUMÉ Tafluprost: La Primera Prostaglandina Libre de Preservativo para Tafluprost: La Première Prostaglandine sans Agent Conservateur Tratar el Glaucoma de Angulo Abierto y la Hipertensión Ocular dans le Traitement du Glaucome à Angle Ouvert et l’Hypertension C Swymer y MW Neville Oculaire C Swymer et MW Neville Ann Pharmacother 2012;46:1506-10.

OBJETIVO: Analizar la farmacología, farmacocinética, datos de estudios Ann Pharmacother 2012;46:1506-10. clínicos, datos de eficacia, y la incidencia de efectos adversos de OBJECTIF: Revoir la pharmacologie, la pharmacocinétique, les études tafluprost. cliniques, les données d’efficacité, et d’innocuité du tafluprost. FUENTES DE INFORMACIÓN: Se completó una búsqueda de la literatura SOURCE DES DONNÉES: Une recherche de la documentation scientifique a utilizando el sistema PubMed, Web of Science, y Google Scholar. été effectuée dans Pub Med, Web of Science et Google Scholar. Le mot Tafluprost fue el término de búsqueda principal. Artículos publicados clé pour la recherche était tafluprost. Les articles publiés entre janvier entre enero 2008 y abril 2012 fueron incluidos en este análisis. 2008 et avril 2012 ont été inclus dans l’article de revue. Les limites Restricciones adicionales aplicadas a la búsqueda fueron los términos incluses dans la stratégie de recherche étaient humain et anglais. Les humano e inglés. Citaciones en donde tafluprost apareció en el título citations dans lesquelles apparaissaient le mot tafluprost dans le titre fueron 36, 29, y más de 500 en PubMed, Web Science, y Google étaient 36, 29, et plus de 300 dans PubMed, Web of Science et Google Scholar, respectivamente. Scholar respectivement. SELECCIÓN DE FUENTES DE INFORMACIÓN Y MÉTODOS DE EXTRACCIÓN DE SÉLECTION DES ÉTUDES ET EXTRACTION DES DONNÉES: Trois études cliniques INFORMACIÓN: Tres estudios Clínicos fueron incluidos en este análisis. ont été incluses dans cette revue. Une étude aléatoire a inclus plus de Un estudió incluyó más de 500 sujetos de forma aleatoria. Otro también 500 patients. Une deuxième étude a également inclus plus de 500 incluyó más de 500 sujetos, a pesar de que el diseño del estudió no fue patients; cependant le devis de cette étude n’était pas aléatoire. La aleatorio. El tercer estudio evaluó los efectos de tafluprost en sujetos que troisième étude a évalué les effets indésirables de patients qui avaient habían descontinuado recientemente el uso de latanoprost, otra récemment cessé le latanoprost. La durée des 3 études était d’une prostaglandina que está aprobada para tratar el glaucoma y la période de 12 semaines. hipertensión ocular. La duración de los 3 estudios fue de 12 semanas. ANALYSE DES DONNÉES: Le tafluprost 0.0015% est la première prostaglan- SÍNTESIS: Tafluprost 0.0015% es la primera prostaglandina tópica dine topique sans agent conservateur (le chlorure de benzalkonium) qui aprobada por la Administración de Drogas y Alimentos para el a été approuvé par la Food and Drug Administration pour le traitement tratamiento de glaucoma de ángulo abierto e hipertensión ocular, que no d’un glaucome à angle ouvert et pour l’hypertension oculaire. Même s’il contiene el preservativo ampliamente utilizado, cloruro de benzalconio existe une certaine controverse quant à la sécurité à long terme du (BAK). Aunque hay controversia que rodea la seguridad a largo plazo chlorure de benzalkonium, les données cliniques ne sont pas concluantes. de la exposición a BAK, datos de estudios clínicos son inconclusos. Le tafluprost exerce son effet au niveau des récepteurs des prostaglandines Tafluprost, al igual que otros análogos de prostaglandina, ejerce su F pour réduire la pression intraoculaire. Les résultats de la première étude efecto en los receptores de prostaglandina F para reducir la presión démontrent une réduction importante de la pression intraoculaire lorsque intraocular (IOP). Los resultados de un estudio clínico demostraron les patients ont été transférés au tafluprost. La réduction de la pression reducciones significativas en IOP cuando se cambiaba de monoterapia a intraoculaire chez les patients sous tafluprost a été comparée aux patients la monoterapia de tafluprost. Las reducciones en IOP con el uso de utilisant le timolol et le latanoprost dans deux études ; un résultat de non tafluprost se compararon con aquellas observadas con el uso de timolol infériorité a été rapporté. Une réduction importante de l’osmolarité des y latanoprost en dos estudios, donde también se observó no inferioridad. larmes a été notée chez les patients qui ont changé de latanoprost au Reducciones significativas en osmolaridad, se observaron en sujetos que tafluprost. L’hyperémie conjonctivale représente l’effet indésirable le cambiaron de latanoprost, otro análogo de prostaglandina, a la terapia de plus souvent observé chez les patients sous prostaglandine topique. Les tafluprost. Hiperemia conjuntival es el efecto adverso más común patients rapportent également une sensation de brûlure, un prurit oculaire, observado en pacientes que reciben drogas de esta clase. Algunos une coloration foncée ou une croissance des cils et une pigmentation también han reportado sensación de picor, picor ocular, oscurecimiento irréversible brune de l’iris. aumentado o crecimiento de las pestañas y oscurecimiento de párpados, CONCLUSIONS: Les études cliniques suggèrent que le tafluprost est aussi así como pigmentación irreversible de color marrón en el iris. efficace que les autres agents topiques dans le traitement du glaucome à CONCLUSIONES: Datos de estudios clínicos sugieren que tafluprost es tan angle-ouvert et l’hypertension oculaire. Il pourrait être prescrit chez les eficaz como otros agentes utilizados en el manejo de hipertensión ocular patients avec allergies, une sensibilité aux agents conservateurs ou chez y glaucoma. Su uso puede ser especialmente ventajoso en personas con les patients avec les yeux secs ou sensibles. alergias, sensibilidades a preservativos u ojos resecos o sensibles. Traduit par Louise Mallet Traducido por Jennifer Guzman

1510 I The Annals of Pharmacotherapy I 2012 November, Volume 46 theannals.com

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