综述
ENGLISH ABSTRACT
不含防腐剂的降眼压药物应用前景
黄晶晶
葛坚 [综述]
作者及单位信息
·
DOI: 10.3760/cma.j.cn115989-20230419-00141
Clinical applications of preservative-free intraocular pressure-lowering drugs: the future prospects
Huang Jingjing
Ge Jian
Authors Info & Affiliations
Huang Jingjing
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
Ge Jian
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
·
DOI: 10.3760/cma.j.cn115989-20230419-00141
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摘要

长期使用局部降眼压药物,尤其是含防腐剂的降眼压药物可能会引起或加重眼表疾病,进而可能降低患者对药物的耐受性及治疗依从性,也可能增加手术相关风险,最终影响青光眼的治疗效果。因此,青光眼的长期管理有必要综合考虑疗效、安全性、经济学等多方面的因素。为避免防腐剂带来的眼表毒性作用,近年来研发不含防腐剂的(PF)降眼压药物开始广受关注。PF-降眼压药物与其相应的含防腐剂药物相比,具有相似的药动学特性和生物等效性;同时,PF类药物的工艺设计可有助于降低眼表疾病的发生,从而改善患者的体征和症状,有助于提高疗效,具有广阔应用前景。本文将针对PF-降眼压药物的发展历史和临床应用进行综述和讨论,以期加深临床医生对此类药物使用的了解。

青光眼;眼压;药物治疗;不含防腐剂;研究进展;未来前景
ABSTRACT

Long-term use of topical intraocular pressure-lowering medications, particularly those containing preservatives, may cause or worsen ocular surface diseases, which may ultimately reduce patient tolerance and compliance, increase surgical risk, and compromise treatment efficacy.Therefore, long-term management of glaucoma requires the consideration of various factors such as efficacy, safety, and cost-effectiveness.Recently, the use of preservative-free (PF) intraocular pressure-lowering drugs has been gaining considerable attention in research as a means to avoid the toxicity of preservatives on ocular health.These drugs have similar pharmacokinetic properties and bioequivalence to their corresponding preservative-containing drugs.In addition, the manufacturing process of PF medications can reduce the incidence of ocular surface diseases, improve patient symptoms, and increase treatment effectiveness, indicating extensive potential applications.This review focuses on the development and clinical use of PF intraocular pressure-lowering drugs, aiming to deepen clinicians' understanding of their use.

Glaucoma;Intraocular pressure;Drug therapy;Preservative-free;Advances;Future prospects
Ge Jian, Email: nc.defudabe.usys.liamnaijeg
引用本文

黄晶晶,葛坚. 不含防腐剂的降眼压药物应用前景[J]. 中华实验眼科杂志,2023,41(12):1231-1236.

DOI:10.3760/cma.j.cn115989-20230419-00141

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青光眼是严重的不可逆性致盲眼病,可导致视觉功能损伤,甚至盲,严重影响患者的行为能力和生活质量,也带来了沉重的经济负担。据估计,2050年中国青光眼患者将达到2 516万例 [ 1 ]。目前,局部使用降眼压药物仍是青光眼的首选治疗方式,一线药物治疗包括前列腺素衍生物(prostaglandin analogues,PGAs)、β肾上腺素能受体阻滞剂(β受体阻滞剂)、α2肾上腺受体激动剂(α受体激动剂)和碳酸酐酶抑制剂等,其中多种降眼压药物的配方中均含有防腐剂,长期使用可引起或加重眼表疾病 [ 2 , 3 ]。因此,青光眼的长期管理仍需解决如何平衡疗效与安全性、耐受性及患者依从性等问题。近年来,眼用防腐剂不断创新,不含防腐剂的(preservative-free,PF)降眼压药物也开始备受关注。本文将从PF降眼压药物的发展历史和应用前景的角度,梳理和探讨其在青光眼患者长期管理中的临床价值。
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参考文献
[1]
Song P Wang J Bucan K et al. National and sub national prevalence and burden of glaucoma in China:a systematic analysis [J/OL]J Glob Health 20177(2)∶020705[2023-01-20]https://pubmed.ncbi.nlm.nih.gov/29302324/. DOI: 10.7189/jogh.07.020705 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Garcia-Feijoo J Sampaolesi JR . A multicenter evaluation of ocular surface disease prevalence in patients with glaucoma[J]Clin Ophthalmol 20126441446. DOI: 10.2147/OPTH.S29158 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Skalicky SE Goldberg I McCluskey P Ocular surface disease and quality of life in patients with glaucoma[J]Am J Ophthalmol 2012153(1)∶19. DOI: 10.1016/j.ajo.2011.05.033 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Servat JJ Bernardino CR . Effects of common topical antiglaucoma medications on the ocular surface,eyelids and periorbital tissue[J]Drugs Aging 201128(4)∶267282. DOI: 10.2165/11588830-000000000-00000 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
European Glaucoma Society Terminology and Guidelines for Glaucoma,5th Edition[J]Br J Ophthalmol 2021105(Suppl 1)∶1169. DOI: 10.1136/bjophthalmol-2021-egsguidelines .
[6]
Li F Huang W Zhang X Efficacy and safety of different regimens for primary open-angle glaucoma or ocular hypertension:a systematic review and network meta-analysis [J/OL]Acta Ophthalmol 201896(3)∶e277e284[2023-01-20]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5947254/. DOI: 10.1111/aos.13568 .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Li T Lindsley K Rouse B et al. Comparative effectiveness of first-line medications for primary open-angle glaucoma:a systematic review and network meta-analysis[J]Ophthalmology 2016123(1)∶129140. DOI: 10.1016/j.ophtha.2015.09.005 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Chamard C Larrieu S Baudouin C et al. Preservative-free versus preserved glauco ma eye drops and occurrence of glaucoma surgery.A retrospective study based on the French national health insurance information system,2008—2016 [J/OL]Acta Ophthalmol 202098(7)∶e876e881[2023-01-20]https://onlinelibrary.wiley.com/doi/10.1111/aos.14410. DOI: 10.1111/aos.14410 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
Boimer C Birt CM . Preservative exposure and surgical outcomes in glaucoma patients:the PESO study[J]J Glaucoma 201322(9)∶730735. DOI: 10.1097/IJG.0b013e31825af67d .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Jackson MA Giyanani J Shabaik Y et al. In vitro and in-eye comparison of commercial pilocarpine ophthalmic solution and an optimized,reformulated pilocarpine for presbyopia treatment [J]Ophthalmol Ther 202211(2)∶869879. DOI: 10.1007/s40123-022-00482-2 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Aydin Kurna S Acikgoz S Altun A et al. The effects of topical antiglaucoma drugs as monotherapy on the ocular surface:a prospective study[J/OL]J Ophthalmol 20142014460483[2023-01-23]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070470/. DOI: 10.1155/2014/460483 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Lusthaus JA Goldberg I Brimonidine and brinzolamide for treating glaucoma and ocular hypertension;a safety evaluation[J]Expert Opin Drug Saf 201716(9)∶10711078. DOI: 10.1080/14740338.2017.1346083 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
Tiedemann D Mouhammad ZA Utheim TP et al. Conjunctival goblet cells,the overlooked cells in glaucoma treatment[J]J Glaucoma 201928(4)∶325333. DOI: 10.1097/IJG.0000000000001168 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Kamath AP Satyanarayana S Rodrigues F Ocular surface changes in primary open angle glaucoma with long term topical anti glaucoma medication[J]Med J Armed Forces India 200763(4)∶341345. DOI: 10.1016/S0377-1237(07)80011-6 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Kuwayama Y Nomura A Prospective observational post-marketing study of tafluprost for glaucoma and ocular hypertension:short-term efficacy and safety[J]Adv Ther 201431(4)∶461471. DOI: 10.1007/s12325-014-0109-9 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Suzuki K Teranishi S Sagara T et al. Safety and efficacy of benzalkonium chloride-optimized tafluprost in Japanese glaucoma patients with existing superficial punctate keratitis[J/OL]J Glaucoma 201524(6)∶e145150[2023-01-23]https://pubmed.ncbi.nlm.nih.gov/24240881/. DOI: 10.1097/IJG.0000000000000020 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Kumagami T Wakiyama H Kusano M et al. Comparison of corneal safety and intraocular pressure-lowering effect of tafluprost ophthalmic solution with other prostaglandin ophthalmic solutions[J]J Ocul Pharmacol Ther 201430(4)∶340345. DOI: 10.1089/jop.2013.0132 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Katsanos A Riva I Bozkurt B et al. A new look at the safety and tolerability of prostaglandin analogue eyedrops in glaucoma and ocular hypertension[J]Expert Opin Drug Saf 202221(4)∶525539. DOI: 10.1080/14740338.2022.1996560 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Coroi MC Bungau S Tit M Preservatives from the eye drops and the ocular surface[J]Rom J Ophthalmol 201559(1)∶25.
返回引文位置Google Scholar
百度学术
万方数据
[20]
刘鲁霞张桂芳王惠萱眼药滴瓶口颈细菌污染原因分析[J]西南国防医药 200212(1)∶4243. DOI: 10.3969/j.issn.1004-0188.2002.01.025 .
返回引文位置Google Scholar
百度学术
万方数据
Liu LX Zhang GF Wang HX . Analysis of causes of bacterial pollution at ophthalmic droppers[J]Med J Nat Defend Forces Southwest China 200212(1)∶4243. DOI: 10.3969/j.issn.1004-0188.2002.01.025 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[21]
Goldstein MH Silva FQ Blender N et al. Ocular benzalkonium chloride exposure:problems and solutions[J]Eye (Lond) 202236(2)∶361368. DOI: 10.1038/s41433-021-01668-x .
返回引文位置Google Scholar
百度学术
万方数据
[22]
马仕洪戴翚胡昌勤国产抗生素滴眼液中抑菌剂应用的合理性分析[J]中国抗生素杂志 202146(3)∶196201. DOI: 10.13461/j.cnki.cja.007146 .
返回引文位置Google Scholar
百度学术
万方数据
Ma SH Dai H Hu CQ . Rationality analysis of antimicrobial preservatives used in domestic antibiotic eye drops[J]Chin J Antibiotics 202146(3)∶196201. DOI: 10.13461/j.cnki.cja.007146 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[23]
Furrer P Mayer JM Gurny R Ocular tolerance of preservatives and alternatives[J]Eur J Pharm Biopharm 200253(3)∶263280. DOI: 10.1016/s0939-6411(01)00246-6 .
返回引文位置Google Scholar
百度学术
万方数据
[24]
Hsu KH Chauhan A Rapid and selective removal of preservative from ophthalmic formulations during eyedrops instillation[J]Eur J Pharm Biopharm 201597(Pt A)∶3038. DOI: 10.1016/j.ejpb.2015.10.004 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
Uematsu M Kumagami T Shimoda K et al. Influence of alkyl chain length of benzalkonium chloride on acute corneal epithelial toxicity[J]Cornea 201029(11)∶12961301. DOI: 10.1097/ICO.0b013e3181dc81b6 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
Walsh K Jones L The use of preservatives in dry eye drops[J]Clin Ophthalmol 20191314091425. DOI: 10.2147/OPTH.S211611 .
返回引文位置Google Scholar
百度学术
万方数据
[27]
Noecker RJ Herrygers LA Anwaruddin R Corneal and conjunctival changes caused by commonly used gl aucoma medications [J]Cornea 200423(5)∶490496. DOI: 10.1097/01.ico.0000116526.57227.82 .
返回引文位置Google Scholar
百度学术
万方数据
[28]
Aihara M Oshima H Araie M Effects of SofZia-preserved travoprost and benzalkonium chloride-preserved latanoprost on the ocular surface—a multicentre randomized single-masked study[J/OL]Acta Ophthalmol 201391(1)∶e7e14[2023-01-23]https://pubmed.ncbi.nlm.nih.gov/23241328/. DOI: 10.1111/j.1755-3768.2012.02565.x .
返回引文位置Google Scholar
百度学术
万方数据
[29]
Ryan G Jr Fain JM Lovelace C et al. Effectiveness of ophthalmic solution preservatives:a comparison of latan oprost with 0.02% benzalkonium chloride and travoprost with the sofZia preservative system [J/OL]BMC Ophthalmol 2011118[2023-01-23]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107821/. DOI: 10.1186/1471-2415-11-8 .
返回引文位置Google Scholar
百度学术
万方数据
[30]
Konstas AG Schmetterer L Katsanos A et al. Dorzolamide/timolol fixed combination:learning from the past and looking toward the future[J]Adv Ther 202138(1)∶2451. DOI: 10.1007/s12325-020-01525-5 .
返回引文位置Google Scholar
百度学术
万方数据
[31]
Aptel F Choudhry R Stalmans I Preservative-free versus preserved latanoprost eye drops in patients with open-angle glaucoma or ocular hypertension[J]Curr Med Res Opin 201632(8)∶14571463. DOI: 10.1080/03007995.2016.1202818 .
返回引文位置Google Scholar
百度学术
万方数据
[32]
Uusitalo H Kaarniranta K Ropo A Pharmacokinetics,efficacy and safety profiles of preserved and preservative-free tafluprost in healthy volunteers[J]Acta Ophthalmol Suppl (Oxf) 2008242713. DOI: 10.1111/j.1755-3768.2008.01380.x .
返回引文位置Google Scholar
百度学术
万方数据
[33]
Hamacher T Airaksinen J Saarela V et al. Efficacy and safety levels of preserved and preservative-free tafluprost are equivalent in patients with glaucoma or ocular hypertension:results from a pharmacodynamics analysis[J]Acta Ophthalmol Suppl (Oxf) 20082421419. DOI: 10.1111/j.1755-3768.2008.01381.x .
返回引文位置Google Scholar
百度学术
万方数据
[34]
Shedden A Adamsons IA Getson AJ et al. Comparison of the efficacy and tolerability of preservative-free and preservative-containing formulations of the dorzolamide/timolol fixed combination (COSOPT™) in patients with elevated intraocular pressure in a randomized clinical trial[J]Graefes Arch Clin Exp Ophthalmol 2010248(12)∶17571764. DOI: 10.1007/s00417-010-1397-7 .
返回引文位置Google Scholar
百度学术
万方数据
[35]
Skov AG Rives AS Freiberg J et al. Comparative efficacy and safety of preserved versus preservative-free beta-blockers in patients with glaucoma or ocular hypertension:a systematic review[J]Acta Ophthalmol 2022100(3)∶253261. DOI: 10.1111/aos.14926 .
返回引文位置Google Scholar
百度学术
万方数据
[36]
Kim KE Lee CK Shin J et al. Comparisons of efficacy and safety between preserved and preservative-free brimonidine tartrate in glaucoma and ocular hypertension:a parallel-grouped,randomized trial[J/OL]Sci Rep 202313(1)∶5700[2023-01-23]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10082039/. DOI: 10.1038/s41598-023-31726-1 .
返回引文位置Google Scholar
百度学术
万方数据
[37]
Hommer A Mohammed Ramez O Burchert M et al. IOP-lowering efficacy and tolerability of preservative-free tafluprost 0.001 5% among patients with ocular hypertension or glaucoma[J]Curr Med Res Opin 201026(8)∶19051913. DOI: 10.1185/03007995.2010.492030 .
返回引文位置Google Scholar
百度学术
万方数据
[38]
Chabi A Baranak C Lupinacci R et al. Preservative-free tafluprost in the treatment of open-angle glaucoma or ocular hypertension in India:a phase Ⅲ clinical trial[J]Int J Clin Pract 201670(7)∶577586. DOI: 10.1111/ijcp.12815 .
返回引文位置Google Scholar
百度学术
万方数据
[39]
Cucherat M Stalmans I Rouland JF . Relative efficacy and safety of preservative-free latanoprost (T2345) for the treatment of open-angle glaucoma and ocular hypertension:an adjusted indirect comparison meta-analysis of randomized clinical trials[J/OL]J Glaucoma 201423(1)∶e6975[ 20 23-01-24 ]https://pubmed.ncbi.nlm.nih.gov/23881267/. DOI: 10.1097/IJG.0b013e3182a075e6 .
返回引文位置Google Scholar
百度学术
万方数据
[40]
Uusitalo H Egorov E Kaarniranta K et al. Benefits of switching from latanoprost to preservative-free tafluprost eye drops:a meta-analysis of two phase IIIb clinical trials[J]Clin Ophthalmol 201610445454. DOI: 10.2147/OPTH.S91402 .
返回引文位置Google Scholar
百度学术
万方数据
[41]
Harasymowycz P Hutnik C Rouland JF et al. Preserved versus preservative-free latanoprost for the treatment of glaucoma and ocular hypertension:a post hoc pooled analysis[J]Adv Ther 202138(6)∶30193031. DOI: 10.1007/s12325-021-01731-9 .
返回引文位置Google Scholar
百度学术
万方数据
[42]
Oddone F Tanga L Kóthy P et al. Treatment of open-angle glaucoma and ocular hypertension with preservative-free tafluprost/timolol fixed-dose combination therapy:the VISIONARY Study[J]Adv Ther 202037(4)∶14361451. DOI: 10.1007/s12325-020-01239-8 .
返回引文位置Google Scholar
百度学术
万方数据
[43]
Hommer A Kimmich F Switching patients from preserved prostaglandin-analog monotherapy to preservative-free tafluprost[J]Clin Ophthalmol 20115623631. DOI: 10.2147/OPTH.S17876 .
返回引文位置Google Scholar
百度学术
万方数据
[44]
Rossi G Scudeller L Lumini C et al. An in vivo confocal,prospective,masked,36 months study on glaucoma patients medically treated with preservative-free or preserved monotherapy [J/OL]Sci Rep 20199(1)∶4282[2023-01-25]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414598/. DOI: 10.1038/s41598-019-41038-y .
返回引文位置Google Scholar
百度学术
万方数据
[45]
Abegão Pinto L Vandewalle E Gerlier L et al. Improvement in glaucoma patient quality of life by therapy switch to preservative-free timolol/dorzolamide fixed combination[J]Ophthalmologica 2014231(3)∶166171. DOI: 10.1159/000356468 .
返回引文位置Google Scholar
百度学术
万方数据
[46]
Lanzl I Hamacher T Rosbach K et al. Preservative-free tafluprost in the treatment of naive patients with glaucoma and ocular hypertension[J]Clin Ophthalmol 20137901910. DOI: 10.2147/OPTH.S41640 .
返回引文位置Google Scholar
百度学术
万方数据
[47]
Uusitalo H Chen E Pfeiffer N et al. Switching from a preserved to a preservative-free prostaglandin preparation in topical glaucoma medication[J]Acta Ophthalmol 201088(3)∶329336. DOI: 10.1111/j.1755-3768.2010.01907.x .
返回引文位置Google Scholar
百度学术
万方数据
[48]
Hommer A Schmidl D Kromus M et al. Effect of changing from preserved prostaglandins to preservative-free tafluprost in patients with glaucoma on tear film thickness[J]Eur J Ophthalmol 201828(4)∶385392. DOI: 10.1177/1120672117753703 .
返回引文位置Google Scholar
百度学术
万方数据
[49]
Misiuk-Hojlo M Pomorska M Mulak M et al. The RELIEF study:tolerability and efficacy of preservative-free latanoprost in the treatment of glaucoma or ocular hypertension[J]Eur J Ophthalmol 201929(2)∶210215. DOI: 10.1177/1120672118785280 .
返回引文位置Google Scholar
百度学术
万方数据
[50]
Feldman RM Cioffi GA Liebmann JM et al. Current knowledge and attitudes concerning cost-effective ness in glaucoma pharmacotherapy:a glaucoma specialists focus group study [J]Clin Ophthalmol 202014729739. DOI: 10.2147/OPTH.S236030 .
返回引文位置Google Scholar
百度学术
万方数据
[51]
Wolfram C Stahlberg E Pfeiffer N Patient-reported nonadherence with glaucoma therapy[J]J Ocul Pharmacol Ther 201935(4)∶223228. DOI: 10.1089/jop.2018.0134 .
返回引文位置Google Scholar
百度学术
万方数据
[52]
Kim DW Shin J Lee CK et al. Comparison of ocular surface assessment and adherence between preserved and preservative-free latanoprost in glaucoma:a parallel-grouped randomized trial[J/OL]Sci Rep 202111(1)∶14971[ 2023 -01-25 ]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298458/. DOI: 10.1038/s41598-021-94574-x .
返回引文位置Google Scholar
百度学术
万方数据
[53]
中华医学会眼科学分会青光眼学组中国抗青光眼药物相关眼表疾病诊疗专家共识(2022年)[J]中华眼科杂志 202258(11)∶868871. DOI: 10.3760/cma.j.cn112142-20220414-00177 .
返回引文位置Google Scholar
百度学术
万方数据
Glaucoma Group of Ophthalmology Branch of Chinese Medical Association. Chinese expert consensus on ocular surface diseases related to topical glaucoma medications (2022)[J]Chin J Ophthalmol 202258(11)∶868871. DOI: 10.3760/cma.j.cn112142-20220414-00177 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[54]
Bagnis A Papadia M Scotto R et al. Antiglaucoma drugs:the role of preservative-free formulations[J]Saudi J Ophthalmol 201125(4)∶389394. DOI: 10.1016/j.sjopt.2011.08.004 .
返回引文位置Google Scholar
百度学术
万方数据
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葛坚,Email: nc.defudabe.usys.liamnaijeg
B
所有作者均声明不存在任何利益冲突
C
国家自然科学基金面上项目 (82271081)
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