Effectiveness and Safety of Additive Therapy and Monotherapy of Glaucoma with Prostamides

Increased intraocular pressure (IOP) is the main risk factor for the development of primary open-angle glaucoma (POAG). Nowadays medicine that reduce IOP remain the main method of treating for POAG. The first-line drugs for POAG are prostaglandin analogues. In Russia, for the first time, it appeared not in the form of a fixed combination (Bimoptic). In this regard it is very important to evaluate the clinical efficacy and safety of Bimoptic as a monotherapy and additive component in the treatment of patients with POAG. Patients and methods. Patients were divided into 3 groups depending on the treatment. Group I comprised of 34 patients with newly diagnosed glaucoma on monotherapy with bimatoprost 0.03 %. Group II consisted of 30 patients who started taking bimatoprost 0.03 % as a replacement for latanoprost 0.005 % or travoprost 0.004 %. There were 32 patients in group III, who were prescribed bimatoprost 0.03 % as an adjuvant therapy for B-blockers (BB) 0.5 % or carbonic anhydrase inhibitors (ICA) 2 %. Results. According to the results of the clinical study, it was found that instillation of Bimoptik as a monotherapy for newly diagnosed POAG leads to a decrease in IOP level by an average of 32.1 % of the initial level. With the additive tactics of assigning Bimoptik to the BB and / or IKA, the level of IOP goes down by 10.6 % more. If prostaglandin is changed to Bimoptik, the level of IOP decreases by 12.6 % of the prostaglandin-associated values. Also according to acquired data, Bimoptik has a low percentage of adverse reactions, slight hyperemia and discomfort were observed in 5.2 % of cases in all groups. Conclution. Bimoptik effectively reduces the level of IOP in both monotherapy and additive tactics with the least adverse reactions.

1. Tham Y. C., Li X., Wong T. Y., Quigley H. A., Aung T., Cheng C. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmol. 2014;121:2081–90. DOI: 10.1016/j. ophtha.2014.05.013

2. Quigley H. Neuronal death in glaucoma. Prog Retin Eye Res. 1999;18(1):39–57. DOI: 10.1016/s1350-9462(98)00014-7

3. Sharif N.A. Glaucomatous optic neuropathy treatment options: the promise of novel therapeutics, techniques and tools to help preserve vision. Neural Regen Res. 2018;13(7):1145–50. DOI: 10.4103/1673-5374.235017

4. Cantor L.B., Hoop J., Morgan L., WuDunn D., Catoira Y. Intraocular pressure-lowering efficacy of bimatoprost 0.03 % and travoprost 0.004 % in patients with glaucoma or ocular hypertension. British Journal of Ophthalmology. 2006;90(11):1370–3. DOI: 10.1136/bjo.2006.094326

5. Авдеев Р.В., Александров А.С., Бакунина Н.А., Басинский А.С. Модель первичной открытоугольной глаукомы: манифестирование и исходы. Клиническая медицина. 2014;12:64–72. [Avdeev A.V., Alexandrov A.S., Bakunina N.A., Basinsky A.S. A model of primary open-angle glaucoma: manifestations and out comes. Clinical Medicine = Klinicheskaya meditsinа. 2014;12:64–72. (In Russ.)].

6. Kerstetter J.R., Brubaker R.F., Wilson S.E., Kullerstrand L.J. Prostaglandin F2α-1-Isopropylester Lowers Intraocular Pressure Without Decreasing Aqueous Humor Flow. Am J Ophthalmol. 1988;105(1):30–4. DOI: 10.1016/00029394(88)90117-1

7. Noecker R.J., Earl M.L., Mundorf T.K., Silverstein S.M., Phillips M.P. Comparing bimatoprost and travoprost in black Americans. Curr Med Res Opin. 2006;22(11):2175–80. DOI: 10.1185/030079906x148418

8. Katz L.J., Cohen J.S., Batoosingh A.L., Felix C., Shu V., Schiffman R.M. TwelveMonth, Randomized, Controlled Trial of Bimatoprost 0.01 %, 0.0125 %, and 0.03 % in Patients with Glaucoma or Ocular Hypertension. Am J Ophthalmol. 2010;149(4):661–71.e1. DOI: 10.1016/j.ajo.2009.12.003

9. Holmstrom S., Buchholz P., Walt J., Wickstrøm J., Aagren M. Analytic review of bimatoprost, latanoprost and travoprost in primary open angle glaucoma. Curr Med Res Opin. 2005;21(11):1875–83. DOI: 10.1185/030079905x65600

10. Mishra D., Sinha B.P., Kumar M.S. Comparing the Efficacy of Latanoprost (0.005 %), Bimatoprost (0.03 %), Travoprost (0.004 %), and Timolol (0.5 %) in the Treatment of Primary Open Angle Glaucoma. Korean Journal of Ophthalmology. 2014;28(5):399. DOI: 10.3341/kjo.2014.28.5.399