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

Purpose: 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 ≥ 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 ≥ 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. Conclusion: 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.