オミデネパグ点眼薬の処方パターンと短期の眼圧下降効果と安全性

Prescription patterns, short-term efficacy and safety of omidenepag eye drops

要約　目的：オミデネパグイソプロピル（オミデネパグ）が使用されている症例の特徴と短期の眼圧下降効果および安全性を後ろ向きに調査する。

対象と方法：2018年12月から4か月間にオミデネパグが投与された緑内障および高眼圧症133例133眼を対象とした。処方パターン，緑内障病型，投与時眼圧，視野障害度（MD値），前投薬を調査した。投与時と投与1か月後の眼圧を比較した。投与後の副作用，中止例を調査した。

結果：処方パターンは，他剤からの変更77例，新規（無治療）50例，他剤に追加6例であった。緑内障病型は正常眼圧緑内障94例，原発開放隅角緑内障32例などであった。投与時眼圧は16.4±5.0mmHg，MD値は−5.53±5.35dB，変更例の前投薬はプロスタグランジン（PG）関連点眼薬58例などであった。PG関連点眼薬からの変更理由は副作用出現32例，眼圧下降効果不十分18例などであった。新規例は正常眼圧緑内障が43例で最も多かった。投与前後の眼圧は変更例は変化なし，新規例は有意に下降した。副作用は7例（5.3％）で出現し，結膜充血が最も多かった。中止例は6例（4.5％）であった。

結論：オミデネパグはPG関連点眼薬の副作用によりPG関連点眼薬から変更，正常眼圧緑内障に新規投与される症例が多い。短期の眼圧下降効果と安全性は良好であった。

Abstract　Purpose：We retrospectively investigated characteristics, short-term efficacy of intraocular pressure（IOP）lowering, and safety in cases who were administered omidenepag isopropyl.

Methods：A total of 133 eyes of 133 patients with glaucoma or ocular hypertension who were administered omidenepag isopropyl between December 2018 and March 2019 were enrolled. Prescription patterns, types of glaucoma, IOP at baseline, visual field defects（mean deviation value）, previous medications were investigated. IOP at baseline and at 1 month after administration were compared. Adverse reactions and dropouts were investigated.

Results：Prescription patterns were switching from other medications in 77, a new administration in 50, additional administration to other medications in 6. There were 94 patients with normal-tension glaucoma, 32 patients with primary open-angle glaucoma, etc. The mean value of IOP at baseline was 16.4±5.0 mmHg, the mean deviation value was −5.53±5.35 dB, and previous medications in patients who switched from other medications were prostaglandin（PG）analogs in 58 and others. Reasons for switching from PG analogs were adverse reactions in 32, insufficient IOP lowering effects in 18, and others. Normal-tension glaucoma was the largest number of types of glaucoma（43 patients）in the new administration cases. IOP before and after administration was not different significantly in the switching cases and significantly decreased in the new administration cases. Adverse reactions were observed in 7 patients（5.3％）, and the largest number of adverse reactions was conjunctival hyperemia. 6 patients（4.5％）discontinued the administration.

Conclusion：There were many patients who switched to omidenepag isopropyl from PG analogs because of adverse reactions and who were administered omidenepag isopropyl newly with normal-tension glaucoma. Short-term efficacy of IOP-lowering and safety were satisfactory.