奈沙地尔/拉坦前列素治疗与拉坦前列素单药治疗降低眼压的比较:系统回顾和荟萃分析。

Q3 Medicine
Korean Journal of Ophthalmology : KJO Pub Date : 2022-10-01 Epub Date: 2022-08-19 DOI:10.3341/kjo.2022.0061
Jong-Wook Lee, Hyeon-Soo Ahn, Jinho Chang, Hye-Young Kang, Dong-Jin Chang, Jae Kyung Suh, Hankil Lee
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引用次数: 2

摘要

目的:奈沙地尔是一种Rho激酶抑制剂,是第一类临床有用的新型降压药物。在本研究中,我们进行了系统的文献综述和荟萃分析,以总结和综合现有的关于奈沙地尔/拉坦前列素固定剂量联合治疗青光眼患者的有效性和安全性的证据。方法:我们在PubMed、Ovid Medline、Embase和Cochrane Central检索到2021年4月的相关研究。使用偏倚风险工具评估研究的质量和证据水平。以降低眼压(IOP)的平均差异来衡量疗效,以FDC治疗、奈沙地尔单药治疗或拉坦前列素单药治疗导致结膜充血(CH)的风险来评估安全性。结果:四项研究符合预定的资格标准,并被纳入meta分析。与接受拉坦前列素单药治疗的患者相比,接受FDC治疗的患者在用药2周和4至6周后IOP降低的平均差异分别为-2.41 mmHg(95%置信区间[CI], -2.95至-1.87)和-1.77 mmHg (95% CI, -2.31至-1.87)。另一方面,在给药4 - 6周后,拉坦前列素单药治疗比奈沙地尔单药治疗在降低IOP方面有更大的效果(平均差异为0.95 mmHg;95% CI, 0.43 ~ 1.47)。与拉坦前列素单药治疗相比,FDC治疗和奈沙地尔单药治疗在第12周发生CH的风险显著更高,其相对比值分别为3.01 (95% CI, 1.95至4.66)和2.33 (95% CI, 1.54至3.54)。结论:奈沙地尔/拉坦前列素FDC治疗降低IOP的效果明显优于单独拉坦前列素。CH的症状大多较轻,在早期的临床试验中,仅有少数青光眼患者因CH而停药。因此,考虑使用奈沙地尔/拉坦前列素FDC治疗青光眼患者是有益的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Comparison of Netarsudil/Latanoprost Therapy with Latanoprost Monotherapy for Lowering Intraocular Pressure: A Systematic Review and Meta-analysis.

Comparison of Netarsudil/Latanoprost Therapy with Latanoprost Monotherapy for Lowering Intraocular Pressure: A Systematic Review and Meta-analysis.

Comparison of Netarsudil/Latanoprost Therapy with Latanoprost Monotherapy for Lowering Intraocular Pressure: A Systematic Review and Meta-analysis.

Comparison of Netarsudil/Latanoprost Therapy with Latanoprost Monotherapy for Lowering Intraocular Pressure: A Systematic Review and Meta-analysis.

Purpose: Netarsudil is a Rho kinase inhibitor and the first new class of clinically useful ocular hypotensive agents. In this study, we conducted a systematic literature review and meta-analysis to summarize and synthesize the available evidence on the efficacy and safety of fixed-dose combination (FDC) therapy with netarsudil/latanoprost in patients with glaucoma.

Methods: We identified relevant studies in PubMed, Ovid Medline, Embase, and Cochrane Central until April 2021. The quality of the studies and the level of evidence were assessed using the Risk of Bias tool. Efficacy was measured as the mean difference in reducing intraocular pressure (IOP), and safety was assessed by the risk of conjunctival hyperemia (CH) due to FDC therapy, netarsudil monotherapy, or latanoprost monotherapy.

Results: Four studies met the predefined eligibility criteria and were included in the meta-analysis. The mean difference in the reduction in IOP after 2 weeks and 4 to 6 weeks of drug administration was -2.41 mmHg (95% confidence interval [CI], -2.95 to -1.87) and -1.77 mmHg (95% CI, -2.31 to -1.87), respectively, in patients receiving FDC therapy versus those receiving latanoprost monotherapy. On the other hand, latanoprost monotherapy had a greater effect in reducing IOP than netarsudil monotherapy after 4 to 6 weeks of administration (mean difference, 0.95 mmHg; 95% CI, 0.43 to 1.47). The risk of CH was significantly higher with both FDC therapy and netarsudil monotherapy compared to latanoprost monotherapy in week 12, where the relative ratio was 3.01 (95% CI, 1.95 to 4.66) and 2.33 (95% CI, 1.54 to 3.54), each.

Conclusions: Netarsudil/latanoprost FDC therapy has a significantly greater effect on reducing IOP than latanoprost alone. The symptoms of CH were mostly mild, and only a few glaucoma patients discontinued the medication owing to CH in earlier clinical trials. Therefore, it would be beneficial to consider the administration of netarsudil/latanoprost FDC therapy in patients with glaucoma.

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来源期刊
Korean Journal of Ophthalmology : KJO
Korean Journal of Ophthalmology : KJO Medicine-Ophthalmology
CiteScore
2.40
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