NTERIOR SEGMENT Glaucoma Treatment
SUSTAINED-RELEASE BIMATOPROST
Keeping glaucoma treatment on target, even for non-compliant patients by April Ingram
I
n managing glaucoma, lowering the intraocular pressure (IOP) and preserving vision are always top priorities. If we can achieve these and, at the same time, support a good quality of life for the patient, then it’s a win-win situation. The go-to, first-line therapy for glaucoma treatment is typically topical prostaglandin analog (PGA) medication. PGAs are the first choice due to their trusted and favorable efficacy and safety profiles, not to mention the added benefit of a oncea-day dosing that patients appreciate and can easily adhere to. However, no matter how easy the medication instructions, compliance can be a challenge for patients. Several studies have shown that patients are not motivated to administer their medication as directed, especially when their glaucoma is still asymptomatic. Some of the reasons given for non-adherence include forgetfulness, difficulty of administration, medication cost and undesirable side effects. Non-compliance and non-adherence can be harmful to the patient and frustrating to the physician.
A Possible Answer to Patient’s Non-Adherence Issues In a perfect world, we could take a page from our vitreoretinal colleagues and deliver a sustained-release product and be assured that even our most noncompliant, no-show patient is taken care of. This perfect world may be on the horizon as sustained-release formulations are already in development – which hold the promise of prolonged drug exposure and specifically targeting intended tissues. This could be the answer to adherence and compliance issues of daily dosing and perhaps even the occurrence of surface and periocular adverse events. Bimatoprost SR is a sustained-release, biodegradable implant currently in clinical development. This tiny, rodshaped implant has a solid reservoir of bimatoprost, held within the biodegradable NOVADUR (Allergan, Dublin, Ireland) drug delivery platform. NOVADUR underwent some modification to ensure a steady-state, non-pulsatile slow release of bimatoprost after it has been placed intracamerally, using a prefilled, single-use applicator.
Backed by Scientific Studies
Sustained release glaucoma treatment is the gift that keeps on giving.
16
|
The promise of slow, controlled release of bimatoprost, which quietly and consistently lowers IOP in glaucoma patients for four to six months after administration, sounds pretty perfect. But what do the studies have to say? Lewis and colleagues published their phase 1/2 study results in the American Journal of Ophthalmology in 2017, comparing the IOP-lowering effects of Bimatoprost SR to
December/January 2020
