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Preservative-Free Latanoprost Eye Drops in Patients with Primary Open-Angle Glaucoma/Ocular Hypertension

Abstract

Latanoprost is an ester prodrug prostaglandin F analogue that is a selective agonist of endogenous prostanoid FP receptors and that reduces intraocular pressure (IOP) by increasing the uveoscleral outflow of aqueous humour. Preservative-free (PF) latanoprost [Monoprost®] is a new formulation of latanoprost that is approved for use in the EU in patients with primary open-angle glaucoma (POAG)/ocular hypertension. This article reviews the clinical pharmacology of this new formulation, focussing on its efficacy and tolerability in this indication. PF latanoprost was efficacious in reducing IOP in a randomized, investigator-masked, multinational trial in patients with POAG/ocular hypertension (n = 404). At days 15, 42 and 84 of follow-up, PF latanoprost was noninferior to benzalkonium chloride-preserved (BAK) latanoprost in terms of reductions in IOP. In this trial, at days 42 and 84 the proportions of patients with conjunctival hyperaemia were significantly lower with PF latanoprost than with BAK latanoprost. Patient subjective ratings of ocular symptoms were also significantly lower with PF latanoprost than with BAK latanoprost. In the absence of head-to-head comparisons with other anti-glaucoma drugs, an adjusted, indirect comparison meta-analysis was performed using data from 21 randomized clinical trials in patients with POAG/ocular hypertension. Based on this analysis, PF latanoprost had similar efficacy to different formulations of three comparator prostaglandin analogues in reducing the patient’s IOP and was associated with a significantly lower risk of developing hyperaemia/ocular redness than these comparators. PF latanoprost offers a useful alternative to the available preserved prostaglandin analogues for the treatment of POAG/ocular hypertension.

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Disclosure

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit. Mark Sanford is a salaried employee of Adis/Springer.

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Correspondence to Mark Sanford.

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The manuscript was reviewed by: Y. Catoira-Boyle, Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA; C.A.B. Webers, Department of Ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands.

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Sanford, M. Preservative-Free Latanoprost Eye Drops in Patients with Primary Open-Angle Glaucoma/Ocular Hypertension. Clin Drug Investig 34, 521–528 (2014). https://doi.org/10.1007/s40261-014-0203-4

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  • DOI: https://doi.org/10.1007/s40261-014-0203-4

Keywords

  • Glaucoma
  • Latanoprost
  • Bimatoprost
  • Benzalkonium Chloride
  • Travoprost