ブリモニジン/チモロール配合点眼薬の処方パターンと短期的効果

Prescriptions and short-term efficacy of brimonidine/timolol fixed combination

要約　目的：ブリモニジン酒石酸塩（ブリモニジン）/チモロールマレイン酸塩（チモロール）配合点眼薬（BTFC）処方症例の特徴と短期的効果を後向きに調査する。

対象と方法：2019年12月〜2020年7月に井上眼科病院でBTFCが新規投与された64例を対象とした。患者背景を調査した。前投薬へ追加症例，変更症例に分け，変更症例では変更前後の眼圧を比較した。

結果：男性31例，女性33例，平均年齢68.7±11.0歳であった。原発開放隅角緑内障43例，続発緑内障13例などであった。眼圧は16.9±5.2mmHg，使用薬剤数は3.6±1.4剤であった。追加症例は4例，変更症例は60例であった。変更症例はブリンゾラミド/チモロール配合点眼薬＋ブリモニジン点眼薬からBTFC＋ブリンゾラミド点眼薬へ変更（A群）32例，β遮断点眼薬からの変更（B群）11例，ブリモニジン点眼薬からの変更5例などであった。眼圧は，A群では変更前16.6±4.3mmHgと変更後16.7±4.6mmHgで同等（p＝0.962），B群では変更前15.8±3.2mmHgに比べて変更後14.4±2.8mmHgに有意に下降した（p＜0.05）。

結論：BTFCは同成分同士の変更，β遮断薬やブリモニジン点眼薬からの変更で使用される頻度が高かった。眼圧は同成分同士の変更では変化なく，眼圧下降効果は良好であった。

Abstract　Purpose：Brimonidine/timolol fixed combination（BTFC）is newly available. In this study, the characteristics and short-term efficacy in patients prescribed with BTFC were retrospectively investigated.

Subjects and methods：The subjects were 64 patients newly administered with BTFC at the Inouye Eye Hospital from December 2019 to July 2020. The patients' characteristics were investigated. They were classified into the adding（BTFC to the previous medications）or switching（to BTFC from the previous medications）group. Intraocular pressure（IOP）values before and after the switching were compared in the switching group.

Results：The patients were 31 men and 33 women, and the mean age was 68.7±11.0. The diagnoses were primary open-angle glaucoma in 43 patients, secondary glaucoma in 13 patients, and others. The mean IOP value was 16.9±5.2 mmHg and the mean number of medications was 3.6±1.4. Four patients were in the adding group and 60 patients were in the switching group. In the switching group, 32 patients（Group A）switched from the combination therapy with brinzolamide/timolol fixed combination and brimonidine to the combination therapy with BTFC and brinzolamide；11 patients（Group B）switched from β-blockers；and 5 patients switched from brimonidine. IOP in A Group was not significantly different before and after switching（16.6±4.3 and 16.7±4.6 mmHg, respectively）, but IOP in B Group had significantly decreased after switching（15.8±3.2 and 14.4±2.8 mmHg, respectively. p＜0.05）.

Conclusions：BTFC is used with high frequency in patients switched between the same ingredients or patients switched from β-blockers or brimonidine. There was no difference in IOP in the switching of medications between the same ingredients. The efficacy of IOP-lowering was satisfactory.