The Experts below are selected from a list of 6153 Experts worldwide ranked by ideXlab platform
A Alm - One of the best experts on this subject based on the ideXlab platform.
-
Latanoprost in the treatment of glaucoma.
Clinical Ophthalmology, 2014Co-Authors: A AlmAbstract:Prostaglandins are approved by the European Glaucoma Society guidelines as first-line treatment for glaucoma. This review focuses on Latanoprost, an ester prodrug of prostaglandin (PG) F2α, which was the first of the currently available topical PGF2α analogs to be launched for glaucoma or ocular hypertension and which still accounts for the majority of prescriptions. It is better absorbed than the parent compound through the cornea, and peak concentration of the active drug is in the aqueous humor 1–2 hours after topical dosing (15–30 ng/mL). Metabolism occurs mainly in the liver. Latanoprost (0.005%) has been very well studied in clinical trials and meta-analyses that show it to be generally as effective as the other PG analogs (bimatoprost, travoprost, and tafluprost) and more effective than timolol, dorzolamide, and brimonidine. Latanoprost has good short- and long-term safety and tolerability profiles. In common with other prostaglandins, it lacks systemic effects, but can cause ocular adverse events such as conjunctival hyperemia, pigmentation of the iris, periocular skin or eyelashes, hypertrichosis, and ocular surface effects or irritation. Latanoprost is significantly better tolerated than either bimatoprost or travoprost. Patients treated with Latanoprost have better compliance and persist with therapy longer than those that are given other drugs. An improved formulation of Latanoprost without the preservative benzalkonium chloride has recently been developed. It is as effective as conventional Latanoprost, has a lower incidence of hyperemia, and can be stored at room temperature. In conclusion, Latanoprost has the best efficacy–tolerability ratio of the PG analogs available for glaucoma treatment, and has good compliance and persistence. These factors should be improved further by the recent development of preservative-free Latanoprost.
-
The short-time effect of Latanoprost on the intraocular pressure in normal pressure glaucoma.
Acta Ophthalmologica Scandinavica, 2009Co-Authors: Daniel Kjellgren, Gordon R. Douglas, Frederick S. Mikelberg, Stephen M. Drance, A AlmAbstract:Latanoprost, a prostaglandin analogue, was given topically to 20 patients with normal pressure glaucoma in a double masked randomized study. Either Latanoprost 0.006% or placebo (vehicle) was administered twice a day for 14 days. Latanoprost caused a statistically significant (p < 0.001) reduction in intraocular pressure from a diurnal baseline level of 16.8 to 14.3 mmHg, as measured on day 14. Latanoprost was well tolerated.
-
The Efficacy and Safety of Unfixed and Fixed Combinations of Latanoprost and Other Antiglaucoma Medications
Survey of Ophthalmology, 2002Co-Authors: Eve J. Higginbotham, Michael Diestelhorst, N Pfeiffer, J F Rouland, A AlmAbstract:Adjunctive therapy for the management of glaucoma is commonly used. Unfixed combinations of the prostaglandin analog Latanoprost and other glaucoma medications have been demonstrated to effectively lower intraocular pressure (IOP). The range of reported additional reductions in IOP compared to a monotherapy baseline are as follows: Latanoprost-timolol (13-37%), Latanoprost-pilocarpine 2% (7-14%), Latanoprost and carbonic anhydrase inhibitors (15-24.1%), and Latanoprost and dipivefrin (15-28%). There is a fixed combination of Latanoprost (0.005%) and timolol (0.5%) that has been investigated in Phase III trials in Europe and the United States. In these trials, it was noted that the efficacy of the fixed combination was superior to either of the monotherapy components. After 12 months of follow-up of patients on fixed combination, there was no evidence of long-term drift. The new formulation appears to be safe and does not demonstrate any more side effects than either of the components. The convenience of a fixed combination may enhance patient compliance. Unfixed combination therapy with Latanoprost and other antiglaucoma medications and the fixed combination formulation of Latanoprost and timolol provide an effective and safe option for lowering IOP in glaucoma patients.
-
Latanoprost and cholinergic agonists in combination.
Survey of ophthalmology, 2002Co-Authors: Carol B Toris, A Alm, Carl B. CamrasAbstract:Latanoprost, a prodrug of a prostaglandin F(2alpha) analog, is a potent ocular hypotensive agent, reducing intraocular pressure (IOP) primarily by increasing aqueous humor drainage through the uveoscleral outflow pathway. Initial assessments in animals found that high concentrations of cholinergic agonists reduced drainage through this pathway and attenuated the effects of a PGF(2alpha) analog. This raised the question of whether Latanoprost would be effective when added to the treatment regimen of patients on pilocarpine or strong miotics. In published clinical studies, Latanoprost was additive to the maximally tolerated medical therapy (which included cholinergic agonists) of glaucoma patients. Multiple doses of physostigmine in healthy volunteers did not block the effect of a single drop of Latanoprost during a 1-day study. One study attempting to find the optimal timing of administration of Latanoprost and pilocarpine claimed to show that additivity was best when pilocarpine was given one hour after Latanoprost in the evening. Two other studies found that the timing of the doses was not important. To explain the additivity of Latanoprost and pilocarpine, aqueous humor dynamics were assessed in ocular hypertensive patients treated for 1 week with each drug alone and then for one week in combination. The results showed that Latanoprost increased uveoscleral outflow, pilocarpine increased outflow facility, and pilocarpine did not block or attenuate the uveoscleral outflow effect of Latanoprost. The result was greater IOP reduction when these drugs were used in combination than when either drug was used alone. All available evidence demonstrates that addition of Latanoprost to the treatment regime of patients already taking cholinergic agonists is an effective, although not necessarily the preferred, combination of medications for the treatment of elevated IOP.
-
Latanoprost: Experience of 2-year treatment in Scandinavia.
Acta Ophthalmologica Scandinavica, 2000Co-Authors: A Alm, Ingmar WidengårdAbstract:. Purpose: The aim of the study was to assess efficacy and side effects of Latanoprost during two years of treatment. Methods: The study was a randomized, parallel group, double-masked, multicenter comparison between Latanoprost and timolol in patients with open angle glaucoma or ocular hypertension, followed by an open-label 18-month extension during which all patients were treated with Latanoprost. Results: Latanoprost caused a marked and sustained reduction of the intraocular pressure (IOP). IOP was reduced from baseline levels 25.1±3.5 mm Hg (mean±SD) in 183 patients initially randomized to treatment with Latanoprost to 17.4±2.9 mm Hg (n=66) after 24 months of treatment. For patients initially randomized to treatment with timolol the corresponding figures were 24.3±2.3 mm Hg (n=72) and 17.4±2.6 (n=41) mm Hg after 18 months of treatment with Latanoprost. Two patients were withdrawn because of uncontrolled IOP and 11 patients required additional timolol treatment to maintain an adequate IOP control. Patients initially treated with timolol and switched to Latanoprost had a further reduction of the IOP of 1.0 mm Hg after 6 months of treatment with Latanoprost (p
J Stjernschantz - One of the best experts on this subject based on the ideXlab platform.
-
ocular and systemic pharmacokinetics of Latanoprost in humans
Survey of Ophthalmology, 2002Co-Authors: Birgitta Sjöquist, J StjernschantzAbstract:Abstract The ocular pharmacokinetics of Latanoprost (13,14-dihydro-17-phenyl-18, 19,20-trinor-PGF 2α -isopropyl ester; Xalatan [Pharmacia-Upjohn, Peapack, NJ]) was studied in patients undergoing cataract surgery using radio-immunoassay, and the systemic pharmacokinetics of Latanoprost was studied in healthy human volunteers with 3 H-Latanoprost as well as radioimmunoassay. After topical application, Latanoprost was rapidly hydrolysed in the cornea and blood. The maximum concentration of the active drug, Latanoprost acid, was detected in the aqueous humor 1–2 hours after topical administration of the clinical dose and amounted to 15–30 ng/ml. The half-life of Latanoprost acid in the aqueous humor was 2–3 hours. In the systemic circulation the peak concentration of Latanoprost acid appeared 5 minutes after topical application and reached a level of 53 pg/ml with an elimination half-life of 17 minutes. In patients that had been on the drug continuously for more than 1 year, 5 out of 10 had plasma levels of Latanoprost acid below the limit of detection ( −7 M, whereas that in plasma was about 10 −10 M or less.
-
Latanoprost as a new horizon in the medical management of glaucoma
Current Opinion in Ophthalmology, 1996Co-Authors: J Stjernschantz, A AlmAbstract:Latanoprost is a new prostaglandin F2 alpha analogue specifically developed for the treatment of glaucoma. Latanoprost is a selective FP receptor agonist, with a primary mode of action of increased uveoscleral outflow of aqueous humor. A dose of 50 micrograms/mL (0.005%) once daily has been found optimal in clinical trials. Latanoprost reduces the nocturnal intraocular pressure in addition to the diurnal, and has been shown to be additive to other glaucoma medication. In long-term phase III clinical trials, Latanoprost 0.005% once daily has been proven to be at least as effective as timolol 0.5% twice a day. The main side effect of Latanoprost is increased iridial pigmentation, which is relatively frequent in patients with mixed color of the iris. This unique side effect is based on the ability of prostaglandins to stimulate melanin formation in melanocytes. The advantages of Latanoprost compared with other glaucoma medication comprise different mode of action, good intraocular pressure-reducing effect, once-daily dosing, and absence of systemic side effects. The long-term consequences of increased iridial pigmentation need to be further studied.
-
effects on intraocular pressure and side effects of 0 005 Latanoprost applied once daily evening or morning a comparison with timolol scandinavian Latanoprost study group
Ophthalmology, 1995Co-Authors: A Alm, J StjernschantzAbstract:PURPOSE To compare the effect on intraocular pressure (IOP) and side effects of 0.005% Latanoprost applied once daily, morning or evening, with 0.5% timolol applied twice daily. METHODS A 6-month randomized, double-masked, multicenter study with three parallel groups was undertaken. Two hundred sixty-seven patients were randomized, 84 to timolol, 89 to Latanoprost in the morning for 3 months and then in the evening for another 3 months, and 94 to Latanoprost with the treatment schedule reversed. RESULTS After 6 months, timolol reduced diurnal IOP from 24.6 to 17.9 mmHg (27%); Latanoprost applied in the morning, from 25.5 to 17.7 mmHg (31%); and Latanoprost applied in the evening, from 24.8 to 16.2 mmHg (35%). The efficacy of Latanoprost applied in the evening was statistically superior to Latanoprost applied in the morning and to timolol (P < 0.001). Latanoprost induced a slight increase in conjunctival hyperemia in 31.4% of treated patients, compared with 15.9% for timolol. Sporadic episodes of mild punctate corneal epithelial erosions were three times as frequent in Latanoprost-treated eyes as in timolol-treated eyes. The most significant ocular side effect was increased pigmentation of the iris observed in five and suspected in seven more Latanoprost-treated eyes. All these eyes had a mixed green-brown or blue/gray-brown iris color. Timolol reduced heart rate by 3 beats/minute (P < 0.005). CONCLUSIONS The effect on diurnal IOP of Latanoprost applied once daily in the evening is superior to that of timolol. The main difference in side effects is increased pigmentation of the iris induced by Latanoprost, most likely due to stimulation of melanogenesis in iris stromal melanocytes.
Eric Yan - One of the best experts on this subject based on the ideXlab platform.
-
comparison of Latanoprost and timolol in pediatric glaucoma a phase 3 12 week randomized double masked multicenter study
Ophthalmology, 2011Co-Authors: Tomoko Maedachubachi, Katherine Chiburris, Brad D Simons, Sharon F Freedman, Peng T Khaw, Barbara M Wirostko, Eric YanAbstract:Objective To compare the efficacy and safety of Latanoprost versus timolol in pediatric patients with glaucoma. Design Prospective, randomized, double-masked, 12-week, multicenter study. Participants Individuals aged ≤18 years with glaucoma. Methods Stratified by age, diagnosis, and intraocular pressure (IOP) level, subjects were randomized (1:1) to Latanoprost vehicle at 8 am and Latanoprost 0.005% at 8 pm or timolol 0.5% (0.25% for those aged Main Outcome Measures Mean IOP reduction from baseline to week 12. Latanoprost was considered noninferior to timolol if the lower limit of the 95% confidence interval (CI) of the difference was >−3 mmHg. A proportion of responders (subjects with ≥15% IOP reduction at weeks 4 and 12) were evaluated. Analyses were performed in diagnosis subgroups: primary congenital glaucoma (PCG) and non-PCG. Results In total, 137 subjects were treated (safety population; 12–18 years, n=48; 3– P =0.21). Responder rates were 60% for Latanoprost and 52% for timolol ( P =0.33). Between-treatment differences in mean IOP reduction for PCG and non-PCG subgroups were 0.6 mmHg (95% CI, −2.3 to 3.4) and 2.6 mmHg (95% CI, −0.8 to 6.1), respectively. Responder rates for Latanoprost versus timolol were 50% versus 46% for the PCG group and 72% versus 57% for the non-PCG group. Both therapies were well tolerated. Conclusions Latanoprost 0.005% is not inferior (i.e., is either more or similarly effective) to timolol and produces clinically relevant IOP reductions across pediatric patients with and without PCG. Both Latanoprost and timolol had favorable safety profiles over the duration of this 3-month trial. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.
William C Stewart - One of the best experts on this subject based on the ideXlab platform.
-
Second-line therapy with dorzolamide/timolol or Latanoprost/timolol fixed combination versus adding dorzolamide/timolol fixed combination to Latanoprost monotherapy
British Journal of Ophthalmology, 2008Co-Authors: Anastasios G. P. Konstas, Dimitrios G. Mikropoulos, A. T. Dimopoulos, G. Moumtzis, Lindsay A. Nelson, William C StewartAbstract:Objective: To evaluate open-angle glaucoma patients, who were insufficiently controlled on Latanoprost monotherapy, to determine the 24 h intraocular pressure (IOP) efficacy and safety when changing them to dorzolamide/timolol (DTFC) or Latanoprost/timolol fixed combination (LTFC) or adding DTFC. Methods: A prospective, observer-masked, placebo-controlled, crossover, comparison. Consecutive adults with primary open-angle or exfoliative glaucoma who exhibit a mean baseline IOP >21 mm Hg on Latanoprost monotherapy were randomised for 3 months to: DTFC, LTFC or DTFC and Latanoprost. Patients were then crossed over to the next treatment for periods 2 and 3. At the end of the Latanoprost run-in and after each 3-month treatment period, patients underwent 24 h IOP monitoring. Results: 31 patients completed this study. All three adjunctive therapies significantly reduced the IOP at each time point and for the mean 24 h curve, except at 18:00 and 02:00 with DTFC and 02:00 with LTFC. When the three treatments were compared directly, the DTFC and Latanoprost therapy demonstrated lower IOPs versus the other treatment groups, including: the mean 24 h pressure, maximum as well as minimum levels and individual time points following a modified Bonferroni correction (p Conclusions: This study showed DTFC, LTFC and the addition of DTFC to Latanoprost significantly decrease the IOP compared with Latanoprost alone, but the latter therapy regime yields the greatest IOP reduction.
-
Twenty-four-hour control with Latanoprost-timolol-fixed combination therapy vs Latanoprost therapy.
Archives of Ophthalmology, 2005Co-Authors: Anastasios G. P. Konstas, Kostantinos G. Boboridis, Despina Tzetzi, Kostantinos Kallinderis, Jessica N. Jenkins, William C StewartAbstract:Objective To evaluate the 24-hour efficacy and safety of the Latanoprost-timolol maleate–fixed combination vs Latanoprost therapy in patients with primary open-angle glaucoma. Methods A prospective, observer-masked, crossover, active-controlled, randomized comparison in which after a 6-week medicine-free period, patients were randomized to either Latanoprost-timolol–fixed combination therapy or Latanoprost therapy, both dosed once each evening, alone for 8 weeks. Patients were then switched to the opposite treatment for 8 weeks. At the end of the washout and treatment periods, a 24-hour diurnal curve was performed. Results The baseline untreated mean ± SD diurnal curve in 37 patients who completed the study was 24.2 ± 2.0 mm Hg. The mean diurnal curve was 19.2 ± 2.6 mm Hg for those who received Latanoprost therapy alone and 16.7 ± 2.1 mm Hg for those who received the fixed combination therapy ( P P P P = .04), but itching was statistically increased compared with the fixed combination therapy ( P = .04). Conclusion The result of this study suggests that the Latanoprost-timolol–fixed combination compared with Latanoprost therapy alone provides improved intraocular pressure reduction over the 24-hour diurnal curve and for each individual time point in patients with primary open-angle glaucoma.
-
conjunctival hyperemia in healthy subjects after short term dosing with Latanoprost bimatoprost and travoprost
American Journal of Ophthalmology, 2003Co-Authors: William C Stewart, Jessica N Leech, Allan E Kolker, Jeanette A. Stewart, Angi L JacksonAbstract:Abstract Purpose To evaluate conjunctival hyperemia after short-term use of Latanoprost 0.005%, bimatoprost 0.03% and travoprost 0.004% in normal adults. Design Prospective, randomized, double-masked crossover active controlled comparison. Methods We evaluated conjunctival hyperemia by a standard photographic measure at the slit lamp and by anterior segment photographs in healthy subjects after dosing for 5 days with Latanoprost, bimatoprost, or travoprost. Conjunctival hyperemia was evaluated at 24-hour trough (hour 0) and at hour 1 after dosing. Each subject was crossed over between periods after a 1-week washout interval. Results Twenty-eight subjects (mean age 26 ± 9 years) completed this study. Several comparisons were noted to be significant between groups by slit-lamp biomicroscopy: first, at hour 0 Latanoprost had significantly less hyperemia than bimatoprost; second, at hour 0 Latanoprost showed significantly less change than bimatoprost compared with the study baseline (visit 2); third, at hour 1 Latanoprost had significantly less hyperemia than travoprost; fourth, at hour 1 Latanoprost demonstrated significantly less change from baseline in hyperemia than travoprost (visit 2); fifth, at hour 1 Latanoprost had less change in hyperemia than bimatoprost or travoprost between the study and the nonstudy eye ( P = .03); and last, at hour 1 Latanoprost showed significantly less change than bimatoprost and travoprost compared with hour 0 ( P = .04). Additionally, similar grades were observed by photographs with Latanoprost demonstrating the lowest levels of hyperemia. Subjects complained less about other people noticing their red eye with Latanoprost than bimatoprost or travoprost ( P = .048). No serious adverse events were noted. Conclusions This study suggests that Latanoprost may cause significantly less short-term conjunctival hyperemia on average than bimatoprost or travoprost in healthy subjects.
-
Washout periods for brimonidine 0.2% and Latanoprost 0.005%.
American Journal of Ophthalmology, 2001Co-Authors: William C Stewart, Keri T Holmes, Mark A JohnsonAbstract:PURPOSE: To evaluate the intraocular pressure washout time after discontinuing brimonidine 0.2% twice daily and Latanoprost 0.005% once every evening. METHODS: We discontinued brimonidine or Latanoprost in a masked fashion from primary open-angle glaucoma or ocular hypertensive patients. The intraocular pressure was measured twice weekly until patients returned to untreated baseline. RESULTS: In 32 patients, the mean longest eye washout time for brimonidine (n = 15) was 3.3 ± 3.0 weeks and for Latanoprost (n = 17) was 4.4 ± 3.2 weeks (P = .24). In all but one patient, brimonidine returned to baseline by 5 weeks and Latanoprost returned by 8 weeks. CONCLUSION: After discontinuing Latanoprost or brimonidine, a wide variation exists in washout times among individuals, with Latanoprost demonstrating a trend to a longer washout period.
Johan Stjernschantz - One of the best experts on this subject based on the ideXlab platform.
-
Ocular and systemic pharmacokinetics of Latanoprost in humans.
Survey of ophthalmology, 2002Co-Authors: Birgitta Sjöquist, Johan StjernschantzAbstract:The ocular pharmacokinetics of Latanoprost (13,14-dihydro-17-phenyl-18, 19,20-trinor-PGF(2alpha)-isopropyl ester; Xalatan [Pharmacia-Upjohn, Peapack, NJ]) was studied in patients undergoing cataract surgery using radio-immunoassay, and the systemic pharmacokinetics of Latanoprost was studied in healthy human volunteers with 3H-Latanoprost as well as radioimmunoassay. After topical application, Latanoprost was rapidly hydrolysed in the cornea and blood. The maximum concentration of the active drug, Latanoprost acid, was detected in the aqueous humor 1-2 hours after topical administration of the clinical dose and amounted to 15-30 ng/ml. The half-life of Latanoprost acid in the aqueous humor was 2-3 hours. In the systemic circulation the peak concentration of Latanoprost acid appeared 5 minutes after topical application and reached a level of 53 pg/ml with an elimination half-life of 17 minutes. In patients that had been on the drug continuously for more than 1 year, 5 out of 10 had plasma levels of Latanoprost acid below the limit of detection (
-
effects on intraocular pressure and side effects of 0 005 Latanoprost applied once daily evening or morning a comparison with timolol
Ophthalmology, 1995Co-Authors: A Alm, Johan StjernschantzAbstract:Abstract Purpose: To compare the effect on intraocular pressure (IOP) and side effects of 0.005% Latanoprost applied once daily, morning or evening, with 0.5% timolol applied twice daily. Methods: A 6-month randomized, double-masked, multicenter study with three parallel groups was undertaken. Two hundred sixty-seven patients were randomized, 84 to timolol, 89 to Latanoprost in the morning for 3 months and then in the evening for another 3 months, and 94 to Latanoprost with the treatment schedule reversed. Results: After 6 months, timolol reduced diurnal IOP from 24.6 to 17.9 mmHg (27%); Latanoprost applied in the morning, from 25.5 to 17.7 mmHg (31%); and Latanoprost applied in the evening, from 24.8 to 16.2 mmHg (35%). The efficacy of Latanoprost applied in the evening was statistically superior to Latanoprost applied in the morning and to timolol ( P P Conclusions: The effect on diurnal IOP of Latanoprost applied once daily in the evening is superior to that of timolol. The main difference in side effects is increased pigmentation of the iris induced by Latanoprost, most likely due to stimulation of melanogenesis in iris stromal melanocytes.
