实践中的证据:无防腐剂塔夫卢前列素(0.0015%)和噻吗洛尔(0.5%)固定剂量复方制剂的实际研究和临床经验综述。

Clinical ophthalmology (Auckland, N.Z.) Pub Date : 2024-11-08 eCollection Date: 2024-01-01 DOI:10.2147/OPTH.S479852
Gábor Hollo
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引用次数: 0

摘要

根据推荐的治疗路径,0.0015%他氟前列素和0.5%噻吗洛尔的无防腐剂固定剂量联合制剂(PF他氟前列素/噻吗洛尔FC)是眼压(IOP)降低的局部疗法之一,常用于眼压过高(OHT)和开角型青光眼(OAG)的二线治疗。近年来,在随机对照试验(RCT)和实际生活研究中,有关PF他氟前列素/噻吗洛尔FC的疗效、安全性和耐受性的证据越来越多。本综述旨在总结已发表的第 IV 期试验和实际生活研究中的关键证据,以突出那些能补充随机对照试验结果并支持实施循证临床实践的数据。本综述从眼科医生在治疗 OHT/OAG 时可能遇到的常见临床情况出发,讨论了现实生活中的疗效和安全性结果。迄今为止进行的 IV 期研究表明,大多数接受局部前列腺素或β-受体阻滞剂单药治疗但眼压控制不佳的 OHT/OAG 患者在改用 PF 他氟前列素/噻吗洛尔 FC 治疗后,眼压可降低≥20%。据报道,从 4 周开始,眼压就会出现统计学意义上的明显下降,并可维持 6 个月。现实生活中的研究和病例系列数据也表明,使用最大/复合局部治疗方案时眼压控制不佳的患者,在降为 PF 他氟前列素/噻吗洛尔 FC 治疗后也能获益,实现显著且持续的眼压降低。许多研究表明,无论是从单一疗法中逐步过渡到帕夫前列素/噻吗洛尔FC疗法的患者,还是简化局部疗法的患者,其耐受性以及眼部健康的症状和体征都有所改善。据临床医生报告,与之前的治疗方法相比,PF 他氟前列素/噻吗洛尔 FC 的治疗依从性更好,这可能与患者对治疗耐受性的体验增强有关,也可能有助于观察到的长期降低眼压疗效。帕夫前列素/噻吗洛尔FC的实际安全性数据反映了已发表的RCT报告的结果。
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Evidence in Practice: A Review of Real-Life Studies and Clinical Experience with the Preservative-Free Tafluprost (0.0015%) and Timolol (0.5%) Fixed-Dose Combination.

The preservative-free fixed-dose combination formulation of 0.0015% tafluprost and 0.5% timolol (PF tafluprost/timolol FC) is among the topical intraocular pressure (IOP)-lowering therapies commonly used second-line for the management of ocular hypertension (OHT) and open-angle glaucoma (OAG), according to recommended treatment pathways. A growing body of evidence has developed in recent years regarding efficacy, safety and tolerability outcomes with PF tafluprost/timolol FC in both randomized controlled trials (RCTs) and real-life studies. This review aims to summarize key evidence from published Phase IV trials and real-life studies to highlight those data that complement RCT findings and support implementation of evidence-informed clinical practice. Real-life efficacy and safety outcomes are discussed through the lens of common clinical scenarios that ophthalmologists may encounter in the management of OHT/OAG. Phase IV studies conducted to date have demonstrated that the majority of OHT/OAG patients insufficiently controlled on topical prostaglandin or beta-blocker monotherapy may achieve IOP reductions of ≥20% following a switch to PF tafluprost/timolol FC therapy. Statistically significant IOP reductions were reported from 4 weeks and maintained through 6 months. Real-life studies and case series data also indicated that patients with poor IOP control on maximal/complex topical regimens benefited from a step down to PF tafluprost/timolol FC therapy, achieving significant and sustained IOP reductions. A number of studies have shown improvements in tolerability and the signs and symptoms of ocular health with PF tafluprost/timolol FC therapy, both in patients stepping up from monotherapy and in those simplifying their topical regimen. Clinicians reported better treatment adherence with PF tafluprost/timolol FC compared with prior treatments, which may have been associated with enhanced patient experience regarding treatment tolerability and is likely to have contributed to the long-term IOP-lowering efficacy outcomes observed. Real-life safety data for PF tafluprost/timolol FC reflect outcomes reported in published RCTs.

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