Switching to Brimonidine/Ripasudil Fixed Combination from Brimonidine + Ripasudil

Abstract

Purpose

A fixed-combination eye drop has several advantages over combination therapy, however, the intraocular pressure (IOP)-lowering efficacy and safety of the newly available brimonidine + ripasudil fixed-combination (BRFC) eye drops after switching from brimonidine + ripasudil is yet to be established. Therefore, this study aimed to retrospectively investigate the 6-month safety, usability, and IOP-lowering efficacy of BRFC switched from brimonidine and ripasudil.

Patients and Methods

Overall, 69 patients with primary open-angle glaucoma (69 eyes) receiving brimonidine + ripasudil were enrolled in this study. Brimonidine + ripasudil was discontinued, and treatment was switched to BRFC without a washout period. The IOP was compared before and at 3 and 6 months after switching to BRFC. The side effects, discontinued cases, and usability (a questionnaire survey) were also investigated.

Results

The IOP was not significantly different after switching to BRFC (15.1 ± 3.3 mmHg at baseline, 15.9 ± 3.6 mmHg after 3 months, and 14.6 ± 3.3 mmHg after 6 months). Adverse reactions occurred in four patients (5.8%): allergic conjunctivitis, two patients; irritation, one patient; and blurred vision, one patient. Treatment was discontinued in five (7.2%) patients owing to allergic conjunctivitis, two patients; increased IOP, two patients; and blurred vision, one patient. In the questionnaire survey, 68 patients with eye pain, 67 with itching, 64 with conjunctival hyperemia, 64 with irritation, and 62 with blurred vision reported no change or improved conditions. Additionally, in response to the question regarding preferences for pre-treatment and fixed combinations, 14 participants (20.2%) favored pre-treatment, while 53 (76.8%) preferred fixed combinations.

Conclusion

The IOP was maintained for 6 months, with satisfactory safety and comfort of use, with BRFC switched from brimonidine and ripasudil.

Keywords:

• adverse reactions
• brimonidine/ripasudil
• intraocular pressure
• fixed combination
• switching
• usability

Abbreviations

BRFC, brimonidine + ripasudil fixed-combination; IOP, intraocular pressure; POAG¸primary open-angle glaucoma; NTG, normal-tension glaucoma.

Data Sharing Statement

The participant data that support the findings of this study are available for 5 years after publication from the corresponding author, K.I., upon reasonable request.

Ethics Approval and Informed Consent

The study protocol was approved by the Ethics Committee of Inouye Eye Hospital and adhered to the principles of the Declaration of Helsinki. Study information was provided by the hospital, and participants had the opportunity to refuse to participate in the study.

Acknowledgments

We would like to thank Editage for English language editing.

Author Contributions

All authors made a significant contribution to the work reported, including in the conception, study design, execution, acquisition of data, analysis and interpretation; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Kenji Inoue received lecture fees from Senju, Otsuka, Kowa, Santen, Allergan Japan, K.K., Novartis, HOYA, Pfizer Japan Inc., Viatris, Rohto Nitten, and Chugai. Minako Shiokawa received lectures from Otsuka. Shiho Kunimatsu-Sanuki has received lecture fees from Santen, Viatris, Otsuka, Kowa, Senju, Nitto Medic, Novartis, and Rohto. Kyoko Ishida received lecture fees from Santen, Senju, Otsuka, Kowa, Wakamoto, and Nitto Medicine. Goji Tomita received a grant from Senju and lecture fees from Kowa pharmaceutical, TOPCON, Viatris, and Nitto Medics. The authors report no other conflicts of interest in this work.

Additional information

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.