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要約 目的:原発性開放隅角緑内障(POAG)および高眼圧症に対する選択的EP2受容体作動薬点眼の有効性と安全性を評価すること。
方法:POAGおよび高眼圧症の127例127眼を対象とした。新規投与群の21眼については本剤の眼圧下降効果を検討し,既存の緑内障点眼から変更した106眼では,眼圧変化とprostaglandin associated periorbitopathy(PAP)の頻度の変化を検討した。途中22眼(17.3%)が効果不十分のため中止した。
結果:新規投与で眼圧は平均4.1mmHg下降し,眼圧下降率は17.8%であった。Non-responderは16.3%であった。β遮断薬からの変更では眼圧は2.0mmHg下降し,下降率は9.7%であった。PAPはみられなかった。従来型プロスタグランジン(PG)製剤からの変更では,眼圧の変化に有意差はなく,PAPが90%減少した。PG配合薬からの変更では,眼圧の変化に有意差はなく,PAPが76%減少した。PAPの状況についてはアンケートにより解析した。
結論:選択的EP2受容体作動薬点眼は,眼圧下降効果は従来型PG製剤と同等で,PG製剤によるPAPを減少させることができ,POAGの治療薬として有望と考えられる。
Abstract Purpose:To investigate the efficacy and safety of a topical selective prostaglandin EP2 agonist for treating primary open angle glaucoma(POAG)and ocular hypertension.
Methods:One hundred and twenty seven eyes of 127 patients with POAG or ocular hypertension were included in this study. The lowering of intraocular pressure(IOP)by the topical selective prostaglandin EP2 agonist was evaluated in 21 naïve eyes. The changes in IOP and incidence of prostaglandin associated periorbitopathy(PAP)were evaluated in the patients whose glaucoma eyedrops were switched to the selective prostaglandin EP2 agonist.
Results:In the naïve eyes, IOP decreased by an average of 4.1 mmHg, and the IOP reduction rate was 17.8%. Non-responder accounted for 16.3% of the patients. The group that received beta-blockers showed reduction in IOP by 2.0 mmHg and did not show any PAP symptoms. The change from the conventional prostaglandin(PG)eyedrops to selective prostaglandin EP2 agonist reduced PAP by 90%, with no significant changes in IOP. There was no significant change in IOP in the group that switched from the PG combination drug, and the incidence of PAP was decreased by 76%.
Conclusion:The selective prostaglandin-EP2 receptor agonist eyedrops had a similar IOP-lowering effect as that of conventional PGs, while also reducing PAP. Therefore, it is promising as a therapeutic agent for POAG and ocular hypertension.
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