拉坦前列素滴眼液与其复合剂的降眼压作用的比较

目的：评价0.005%拉坦前列素滴眼液＋0.5%噻吗洛尔滴眼液治疗原发性开角形青光眼患者的替代降眼压作用及其安全性。方法应用0.005%拉坦前列素滴眼液单一治疗的原发性开角型青光眼患者31例,给予0.005%拉坦前列素滴眼液＋0.5%噻吗洛尔滴眼液替代治疗。每晚点药1次,每次1滴。将连续点药后4、8、12周的眼压与基线眼压进行比较研究,同时观察血压、心率等全身及局部不良反应。结果0.005%拉坦前列素滴眼液＋0.5%噻吗洛尔滴眼液可以更有效降低眼压。连续点药4、8、12周后,与基线相比,眼压分别额外下降（2.2±1.1）mmHg、（2.0±0.9）mmHg、（2.2±1.0）mmHg,差异均具有统计学意义（P〈0.05）。连续点药4、8、12周后,获得至少2mmHg眼压下降值的患者百分率分别为64.5%、61.3%、64.5%。心动过缓（3.2%）是最严重的不良反应。结论0.005%拉坦前列素＋0.5%噻吗洛尔复方滴眼液能够更加有效的降低目标眼压,可以作为0.005%拉坦前列素滴眼液的替代治疗手段。     

拉坦前列素联合马来酸噻吗洛尔滴眼液降低眼压的效果观察

目的：探讨拉坦前列素联合马来酸噻吗洛尔固定组合滴眼液降低眼压的效果和安全性。方法将80例高眼压患者根据随机数字表法分为观察组和对照组,观察组患者给予拉坦前列素联合马来酸噻吗洛尔固定组合滴眼液治疗,对照组只给予拉坦前列素滴眼液治疗。随访8周,检测1、2、4、8周末患者的眼压,对治疗前后两组患者的眼压变化进行比较。并记录治疗过程中的患者临床症状及副作用。结果观察组及对照组患者治疗1周、2周、4周、8周时眼压较治疗前显著下降,差异具有统计学意义（ t＝4．41、3．23、3.02、2．53,均P＜0．05）;对两组患者治疗1周、2周、4周、8周眼压值进行比较发现,观察组患者眼压下降明显,差异具有统计学意义（t＝4．41、2．89、2．78、2．43;P＝0．00、0．01、0．01、002）;对两组患者治疗过程中副反应发生情况进行比较发现,差异无显著统计学意义（χ2＝0．05,P＝0．82）。结论拉坦前列素联合马来酸噻吗洛尔固定组合滴眼液可以显著降低青光眼患者的眼压,且其疗效安全,值得应用。     

拉坦前列素用于常规抗青光眼药不能控制眼压者的疗效观察

目的:观察拉坦前列素治疗常规抗青光眼药不能控制眼压的闭角型青光眼的疗效。方法:用其它抗青光眼药眼压控制未达正常的闭角型青光眼患者23例36只眼,给予拉坦前列素单独用药或联合噻吗洛尔、毛果芸香碱,用药6个月,观察眼压、视力、视野及不良反应。结果:急性闭角型青光眼慢性期组治疗前平均眼压(27.13±5.21)mmHg,治疗6个月平均眼压(16.21±3.45)mmHg,治疗前、后差异有统计学意义(P<0.05);慢性闭角型青光眼组治疗前平均眼压(23.25±7.71)mmHg,治疗6个月平均眼压(17.19±3.64)mmHg,治疗前、后差异有统计学意义(P<0.05)。所有病例视力、视野无变化,不良反应轻微。结论:对于用其它抗青光眼药不能控制眼压的闭角型青光眼患者,拉坦前列素单独用药或联合用药效果良好。     

拉坦前列素与噻吗洛尔不同联用方案治疗原发性开角型青光眼的临床观察

目的:观察拉坦前列素与噻吗洛尔不同联用方案治疗原发性开角型青光眼(POAG)的临床疗效与安全性。方法:采用2×2自身交叉对照方案,选择2014年1月-2016年11月在三亚市人民医院接受治疗的50例POAG患者,按随机数字表法分为A、B两个治疗顺序组,各25例。A组患者先行传统用药方案(拉坦前列素滴眼液每晚1次,每次1滴+马来酸噻吗洛尔滴眼液早晚各滴1次,每次1滴),治疗8周后,经48 h洗脱期,再行改进用药方案(拉坦前列素滴眼液每晚1次,每次1滴+马来酸噻吗洛尔滴眼液每日早上1次,每次1滴)治疗8周;B组患者则先行改进治疗方案治疗,治疗8周后,经48 h洗脱期,再行传统治疗方案治疗8周。比较两种用药方案患者用药前后24 h平均眼压、峰值眼压、谷值眼压及眼压波动值,并记录其眼部血流动力学[最大舒张末期血流速度(EDV)、最大收缩期峰值血流速度(PSV)、阻力指数(RI)]及不良反应发生情况。结果:两种用药方案治疗后,患者24 h平均眼压、峰值眼压、谷值眼压、眼压波动值及RI均显著低于治疗前,EDV、PSV均显著高于治疗前,差异均有统计学意义(P<0.05),但两组间比较差异均无统计学意义(P>0.05)。改进用药方案患者的不良反应总发生率显著低于传统用药方案(4.0%vs.22.0%),差异均有统计学意义(P<0.05)。结论:将拉坦前列素联合噻吗洛尔的传统联用方案中的噻吗洛尔早晚2次用药改为早上1次用药,不改变其疗效,但用药不良反应有所减少。     

前列腺素衍生物拉坦前列素(适利达)与噻吗心安治疗青光眼的临床对比研究

目的 :验证前列腺素衍生物拉坦前列素 (适利达 )治疗青光眼的临床疗效和安全性。方法 :采用双盲、随机对照的方法 ,对46例原发性开角型青光眼和高眼压症患者进行为期12周的研究 ,观察其降眼压疗效和不良反应。用0 005 %拉坦前列素每日滴眼1次与0 5 %噻吗心安每日滴眼2次进行随机对比。治疗前 ,治疗后2周、6周及12周随访 ,测量眼压并观察眼局部及全身不良反应。结果 :在入选的46例患者中 (拉坦前列素组22例 ,噻吗心安组24例 ) ,拉坦前列素组平均眼压下降值为 (7 86±2 39)mmHg(下降31 1 % ,P<0 001) ;噻吗心安组为 (6 24±2 58)mmHg(下降24 9 % ,P<0 001)。两组之差1 62mmHg(P<0 01)。拉坦前列素组2例有眼部异物感及充血 ,未发现其他与药物有关的眼部和全身不良反应。结论 :拉坦前列素的降眼压疗效优于噻吗心安 ,且无明显毒、副作用 ,1天仅用1次 ,是理想的抗青光眼药物。     

拉坦前列腺素联合噻吗心安治疗原发性开角型青光眼的疗效观察

目的评价拉坦前列腺素联合噻吗心安对控制原发性高眼压型开角型青光眼的治疗效果。方法前瞻性随机对照研究,2010年8月到2011年11月门诊初次诊断为早期开角型青光眼病人,且眼压高于21mmHg。按照实验组和对照组2∶1的原则,将入选者纳入分析。实验组给予0.5%噻吗心安眼液每天两滴,联合0.005%拉坦前列腺素每晚一滴,对照组只给予0.5%噻吗心安眼液,1周和1个月后复诊测量眼压。结果共38例成功纳入分析,其中实验组27例,对照组11例。用药1周后复查眼压,实验组对对照组眼压低,差异有统计学意义(14.52±1.48vs.18.68±2.01,P<0.001),1月后,实验组仍低于对照组(15.36±1.61 vs.18.66±1.60,P<0.001)。结论相比于单纯用噻吗心安眼液,联合拉坦前列腺素可以更好地控制青光眼患者眼压水平。     

拉坦前列腺素联合马来酸噻吗洛尔治疗原发性开角型青光眼的疗效观察

目的观察与探究拉坦前列腺素联合马来酸噻吗洛尔治疗原发性开角型青光眼的疗效。方法选取2014年03月至2017年03月于本院就诊及治疗的80例原发性开角型青光眼患者(80只患眼)作为研究对象,按照随机数字表法分为两组,每组各有40例患者(40只患眼),对对照组患者给予拉坦前列腺素治疗,对观察组患者给予拉坦前列腺素联合马来酸噻吗洛尔治疗,对比并分析两组患者的效果。结果观察组患者的治疗总有效率(90.00%)与对照组患者(62.50%)相对比,组间差异比较明显(P<0.05),观察组患者治疗之后的眼压水平为(19.20±2.01)mmHg,与对照组患者的(24.16±2.61)mmHg相对比,组间差异比较明显(P<0.05)。结论对原发性开角型青光眼患者使用拉坦前列腺素联合马来酸噻吗洛尔治疗的效果较好。     

拉坦前列素滴眼液治疗青光眼

目的 :观察用降眼压药物而眼压不能控制的病人 ,加用拉坦前列素滴眼液治疗的临床疗效。方法 :2 4例病人 (共 2 4只病眼 ) ,男性 10例 ,女性 14例 ,年龄 (5 0±s12 )a ,共 2 4只病眼用 2种以上降眼压药物而眼压不能控制 ,加用 0 .0 0 5 %拉坦前列素滴眼液滴病眼 ,每晚 1次 ,疗程至少 3mo。结果 :用2种降眼压药有 9例 (38% ) ,用 3种以上降眼压药15例 (6 2 % ) ,其中有 8例 (33% )需口服乙酰唑胺片降眼压。 2 4例病人加用 0 .0 0 5 %拉坦前列素滴眼液 1wk ,1mo和 3mo后 ,眼压由 (3.6 4± 0 .18)kPa降至 (2 .19± 0 .11)kPa ,(2 .18± 0 .11)kPa ,(2 .14 0± 0 .0 10 )kPa ,均P <0 .0 1。眼压降至正常 15例 (6 2 % ) ,眼压降低但未至正常 7例 (2 9% ) ,无效为 2例 (8% )。结论 :对用降眼压药物而眼压不能控制的病人 ,加用拉坦前列素滴眼液可以有效的控制眼压 ,防止青光眼对视功能的进一步损伤     

拉坦前列素与噻吗心安对原发性开角型青光眼患者眼压和眼血流的影响

目的研究拉坦前列素和噻吗心安连续应用12周对原发性开角型青光眼患者降眼压作用和对眼血流的影响。方法选择原发性开角型青光眼患者218例,随机分成2组：拉坦前列素组和噻吗心安组。分别滴用0.005%拉坦前列素每日1次和0.5%噻吗心安每日2次,疗程均为12周。观察眼压及眼血流动力学参数变化。结果2组患者治疗后眼压均有明显下降,且眼压下降平稳恒定;但拉坦前列素组降眼压作用更强大（P〈0.05）。拉坦前列素组视网膜中央动脉（CRA）和睫状后动脉（PCA）的各项血流动力学指标与治疗前相比有显著差异（P〈0.05）,血流的收缩期峰值流速（PSA）和舒张末期流速（EDV）较治疗前均增加,阻力指数（RI）较治疗前降低,而噻吗心安组CRA和PCA的各项血流动力学指标与治疗前相比差异无统计学意义（P〉0.05）。结论拉坦前列素对原发性开角型青光眼患者降眼压疗效及改善眼血流作用优于噻吗心安,且无明显毒、副作用,是理想的抗青光眼药物。     

贝美前列素治疗原发性开角型青光眼和高眼压症的最小成本分析

目的：对贝关前列素滴眼液与同类对照药物拉坦前列素滴眼液治疗原发性开角型青光眼和高眼压症进行药物经济学评价。方法：应用最小成本分析,对参加多中心临床试验医院采用回顾性调查收集费用数据并进行测算。结果：从药物费用上比较两药6周费用之差33．52—35．28元,从6个月诊疗总费用上看,贝美前列素滴眼液的诊疗费用439．6-918．3元,拉坦前列素滴眼液的诊疗费680．8～1062．0元,诊疗总费用在四个地区情况均为贝美前列素低于拉坦前列素。结论：贝美前列素滴眼液治疗相比于拉坦前列素治疗是经济的治疗方案,值得推荐应用。     

Observational study of patients switched to the fixed travoprost 0.004%/timolol 0.5% combination in Croatia

The purpose of this study was to assess both the benefits of a 3-month travoprost 0.004%/timolol 0.5%fixed combination (trav/tim) regimen in comparison with previous medications for the control of intraocular pressure (IOP) and the tolerability of these drug regimens in glaucoma patients. An observational, non-interventional, open-label study of 406 eyes with primary open angle glaucoma and ocular hypertension was thus undertaken. One drop of trav/tim fixed combination was administered in the evening for 3 months. Patients were divided into five groups according to previous drug regimens: timolol 0.5% monotherapy; betaxolol 0.5% monotherapy; latanoprost 0.005% monotherapy; travoprost 0.004% monotherapy; and dorzolamide 2%/timolol 0.5% fixed combination. Upon medication substitution, the trav/tim fixed combination provided better IOP control and tolerability in all five patient groups. At the 3-month follow up, the mean IOP changes from previous therapy were as follows: 5.2 ± 2.7 mmHg (20.8% change) in timolol 0.5% group; 5.7 ± 2.2 mmHg (22.5% change) in betaxolol 0.5% group; 3.8 ± 2.6 mmHg (24.5% change) in latanoprost 0.005% group; 4.4 ± 2.8 mmHg (20% change) in travoprost 0.004% group; and 3.4 ± 4.1 mmHg (14.5% change) in dorzolamide 2%/timolol 0.5% fixed combination group. The difference between baseline and trav/tim combination patient satisfaction at the 3-month follow-up was significant. Thus, the trav/tim fixed combination provided better IOP control and tolerability than previous mono- or polytherapies.     

马来酸噻吗洛尔与布林佐胺联合曲伏前列素治疗开角型青光眼和高眼压症临床研究

目的对比评价马来酸噻吗洛尔与布林佐胺联合曲伏前列素治疗开角型青光眼和高眼压症的临床疗效。方法将我院使用曲伏前列素单药治疗效果不佳的开角型青光眼与高眼压的76例患者分为S组和B组,S组38例(38眼)患者在曲伏前列素基础上合用马来酸噻吗洛尔治疗,B组38例(38眼)患者则合用布林佐胺治疗,于2周和1、3、6个月随访。对比观察两组治疗前后的平均眼压、昼夜眼压差、心率、血压和不良反应发生情况。结果两组患者在联合用药后2周和1、3、6个月平均眼压下降,与治疗前比较差异均有统计学意义(P<0.05),两组间差异无统计学意义(P>0.05);S组联合用药后6个月昼夜眼压差较B组大,两组差异有统计学意义(P<0.05);两组患者在联合用药前后血压均无明显变化(P>0.05);B组患者心率在联合用药前后无明显变化(P>0.05),S组患者心率则在随访6个月时出现明显心脏抑制(P<0.05);两组均未出现严重不良反应。结论马来酸噻吗洛尔与布林佐胺联合曲伏前列素治疗开角型青光眼和高眼压疗效显著,布林佐胺联合曲伏前列素用药相对更稳定、更安全。     

Travoprost/timolol

Travoprost 0.004%/timolol 0.5% fixed combination (travoprost/timolol) is a once-daily eyedrops solution comprising the prostaglandin F(2alpha) analogue travoprost and the beta-adrenoceptor antagonist timolol. It is indicated for the treatment of patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to topical beta-adrenoceptor antagonists or prostaglandin analogues. Once-daily travoprost/timolol had generally similar efficacy to travoprost plus timolol and was more effective than travoprost or timolol monotherapy in reducing intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension in randomised, well designed studies. Both travoprost/timolol and latanoprost plus timolol maintained IOP control, and travoprost/timolol was shown to be noninferior to latanoprost/timolol in randomised, well designed studies. Travoprost/timolol was generally well tolerated, with a tolerability profile similar to those of travoprost plus timolol, travoprost or timolol monotherapy and latanoprost plus timolol. The majority of adverse events, such as ocular hyperaemia, were mild and resolved with or without treatment.     

Circadian intraocular pressure and blood pressure reduction with timolol 0.5% solution and timogel 0.1% in patients with primary open-angle glaucoma

Purpose: To investigate the circadian and blood pressure (BP) reduction obtained with timolol maleate 0.5% solution administered twice daily versus timolol 0.1% in gel-forming carbomer administered in the morning in patients with primary open-angle glaucoma (POAG). Methods: This investigator-masked, crossover study prospectively enrolled naive POAG patients not receiving systemic cardiovascular medications. Following a baseline evaluation, they were randomized to receive a timolol 0.5% solution or timolol 0.1% hydrogel for 2 months and then switched to the alternative medication for a further 2 months. Intraocular pressure (IOP) phasing (sitting Goldmann tonometry at 10 am, 2 pm, 6 pm, and 10 pm and supine Perkins tonometry at 2 am and 6 am) and ambulatory home BP monitoring were measured at baseline and after each treatment period. Results: On the basis of a prospective sample size estimate, 28 patients were analyzed. Mean 24-hour IOP decreased from 23.1 ± 0.7 mm Hg at baseline to 18.9 ± 0.6 mm Hg after timolol 0.5% and 18.9 ± 0.8 mm Hg after timolol 0.1% hydrogel (P < .001); both formulations also significantly decreased diurnal, nocturnal, and individual time point IOP in a statistically similar manner. Systolic and diastolic BP remained generally unaffected. The calculated diastolic ocular perfusion pressure was either unaffected or tended to increase with either medication. Conclusion: Both timolol formulations show similar and significant circadian efficacy and have minimal effects on BP and calculated diastolic ocular perfusion pressure.     

抗青光眼新药莱它诺的合成及其降眼压作用

以科瑞醇（１）为起始原料，经过１０步反应合成得到了抗青光眼新药莱它诺（１１）；经红外光谱、核磁共振谱、质谱及元素分析等确证结构。通过药理试验证明其具有良好的降眼压作用；０．０１％的莱它诺滴眼液对急、慢性眼高压均具有良好的降眼压作用，用药１ｈ和６ｈ后能使眼压分别降低２．９８ｍｍＨｇ和１０．６６ｍｍＨｇ；而阳性对照组仅为２．０１ｍｍＨｇ和８．０２ｍｍＨｇ；与０．５％的噻吗洛尔相比有显著性差异。     

Switching from concomitant latanoprost 0.005% and timolol 0.5% to a fixed combination of travoprost 0.004%/timolol 0.5% in patients with primary open-angle glaucoma and ocular hypertension: a 6-month,multicenter, cohort study

Purpose: To assess the usefulness and tolerability of systematically switching glaucoma patients from latanoprost 0.005% and timolol 0.5% (Lat + Tim) to a fixed combination of travoprost 0.004%/timolol 0.5% (TTFC), and to record the effects of this switch on tear-film break-up time (TBUT). Main outcome measures: Intraocular pressure (IOP) reduction, patients reaching IOP < 18 mmHg; the rate of discontinuation; TBUT; and the onset of adverse events (AEs). Methods: Multicenter, observational cohort, 6-month study: 309 patients on concomitant Lat + Tim were switched to TTFC (evening dosage). IOP, TBUT, and AEs were recorded at baseline and after 1 and 6 months. Results: IOP was significantly decreased (from 18.3 ± 2.9 to 16.6 ± 2.7 mmHg) after substitution (p < 0.0001). Many patients (82%) reached an IOP < 18 mmHg (p < 0.0001). TBUT improved significantly (from 8.4 ± 3.6 to 9.2 ± 3.8 s, p < 0.0001). A few patients reported AEs (8.7%), which caused discontinuation in a low percentage (4.5%). Conclusion: TTFC appeared useful in this selected population. In this study, patients who underwent a regimen modification to TTFC obtained further reduction in IOP with a lower exposition to preservative toxicity. The low discontinuation rate at 6 months indicates a good tolerability profile.     

Concomitant administration of travoprost and brinzolamide versus fixed latanoprost/timolol combined therapy: three-month comparison of efficacy and safety

PURPOSE: To compare the efficacy and safety of the concomitant administration of travoprost 0.004% once daily and brinzolamide 0.1% twice daily with those of a fixed combination of latanoprost 0.005%/timolol 0.5% once daily. RESEARCH, DESIGN AND METHODS: Forty-four patients with primary open-angle glaucoma or ocular hypertension with elevated IOP insufficiently responsive to monotherapy were randomly assigned to one of the two treatment groups: concomitant administration of travoprost 0.004% once daily and brinzolamide 0.1% twice daily (TB group: 22 patients) or latanoprost 0.005% plus timolol 0.5% once daily (LT group: 22 patients). Visits were undertaken at screening (current ocular hypotensive therapy was discontinued), baseline (randomization), and after 2 weeks, 1 month, 2 months and 3 months of therapy. MAIN OUTCOME MEASURES: IOP was determined at 9 a.m., 12 p.m. and 4 p.m. at each study visit, and diurnal IOP was calculated as the mean of these recordings. Adverse events were recorded at each visit. RESULTS: IOP at the baseline visit was similar in both groups. Overall mean IOP was significantly lower in the TB as compared to the LT group after 1 month, 2 month and 3 month follow-up; only 9 a.m. measurements were significantly different, reaching a maximum difference (16.9 +/- 0.9 mmHg vs 18.4 +/- 1.8 mmHg, p < 0.001) at the 3 month check. The percentage of responders (IOP decrease > or = 30%) was higher in the TB group. Both treatments were well tolerated and there were no cases of withdrawal from treatment. CONCLUSIONS: Travoprost 0.004% and brinzolamide 0.1% concomitant therapy showed a greater efficacy than the fixed latanoprost 0.005%/timolol 0.5% combination in terms of absolute IOP decreases. Travoprost/brinzolamide therapy also offered the advantages of a greater percentage of responders.