ブリモニジン点眼薬からブリモニジン／ブリンゾラミド配合点眼薬あるいはブリモニジン／リパスジル配合点眼薬への変更

Six-month efficacy and safety of changing to a brimonidine/brinzolamide or brimonidine/ripasdil fixed combination from brimonidine

要約　目的：ブリモニジン点眼薬（BRM）からブリモニジン／ブリンゾラミド配合点眼薬（BBFC）あるいはブリモニジン／リパスジル配合点眼薬（BRFC）への変更による効果と安全性を後ろ向きに検討する。

対象および方法：BRMからBBFCあるいはBRFCへwashout期間なしで変更した原発開放隅角緑内障59例59眼を対象とした。変更前と変更3，6か月後の眼圧を比較し，副作用と中止例を調査した。

結果：眼圧は，BBFC群（32例）は変更前16.2±3.5mmHgより変更3か月後15.2±3.5mmHg，6か月後14.6±3.2mmHgで有意に下降した（p＜0.01）。BRFC群（27例）は変更前15.8±2.5mmHgより変更3か月後14.9±2.1mmHg，6か月後13.5±2.5mmHgで有意に下降した（p＜0.01）。両群間で眼圧下降幅，眼圧下降率に統計学的有意差はなかった。副作用は，BBFC群において5例（15.6％）に出現し，霧視，眼刺激，光視症，結膜炎，結膜充血＋眼瞼炎が各1例，BRFC群において3例（11.1％）に出現し，眼瞼炎2例，羞明1例であった。中止例はBBFC群が7例（21.9％）で，副作用出現5例，眼圧上昇2例であった。BRFC群が4例（14.8％）で，副作用出現2例，眼圧上昇1例，手術施行1例であった。両群間で副作用や中止例の出現頻度は同等であった。

結論：BRMからBBFCあるいはBRFCへ変更した症例の眼圧下降効果と安全性は同等で，良好であった。

Abstract　Purpose：To retrospectively assess the efficacy and safety of changing from brimonidine eye drops（BRM）to brimonidine/brinzolamide combination（BBFC）or brimonidine/ripasudil combination（BRFC）.

Subjects and Methods：A total of 59 patients who changed from BRM eye drops to BBFC or BRFC eye drops were included the study. Intraocular pressure（IOP）before and after changing eye drops was compared and adverse reactions, and dropouts were recored.

Results：IOP significantly decreased in the BBFC group（32 patients）at three months 15.2±3.5 mmHg and six months 14.6±3.2 mmHg after changing compared with before changing（16.2±3.5 mmHg, p＜0.01）, and in the BRFC group（27 patients）at three months 14.9±2.1 mmHg and six months 13.5±2.5 mmHg after changing compared with before changing（15.8±2.5 mmHg, p＜0.01）. The range of reduction in IOP and reduction in IOP were similar in both groups. There were five adverse reactions in BBFC group（15.6％）；one each of foggy vision, ocular irritation, photopsia, conjunctivitis, conjunctival hyperemia and blepharitis, and three adverse reactions（11.1％）in the BRFC group；two blepharitis and one photophobia. There were seven（21.9％）discontinuations in the BBFC group；five adverse reactions and two increased intraocular pressure, and four discontinuations（14.8％）in the BRFC group；two adverse reactions, one increased intraocular pressure, and one surgery. Frequency of occurrence of adverse reactions and discontinuations were comparable in both groups.

Conclusions：The efficacy of the decreased IOP and safety in patients who changed from BRM eye drops to BBFC or BRFC eye drops were comparable and with good outcomes.