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Breakout data from travoprost study links effectiveness, race
Black patients taking Travatan had more lowering of IOP and responded to the drug in greater numbers.
KOLOA, Hawaii — Alcon’s newest glaucoma drug, Travatan (travoprost), showed significantly improved clinical results versus other glaucoma drugs in a recent study.
The Travatan studies were well done and cross-referenced, which allowed Eve Higginbotham, MD, to break out the results in black patients.
“Because there were such a large number of African-American patients in the study, the statisticians were able to determine if there was actually a significant difference in the efficacy, comparatively, in this subgroup of patients,” she said.
The breakout of data looked at travoprost 0.004% versus Xalatan (latanoprost, Pharmacia) versus timolol in black patients.
Greater efficacy than latanoprost
Of the black patients in a larger, prospective randomized trial, 43 patients were given latanoprost and 49 were given travoprost. Travoprost appeared to work more effectively compared with latanoprost. The study showed travoprost lowered mean intraocular pressure (IOP) in black patients by at least 1.3 mm Hg more than latanoprost over all time-points, and by 2.4 mm Hg at the 2-week visit.
Compared with the other arms of this study, travoprost used in blacks proved to have a much greater effect than on patients who were of other racial or ethnic groups, as well as those patients who were black who were taking latanoprost.
“Travatan evidenced some comparative efficacy that is superior compared to these other groups. So I think that’s very, very interesting,” Dr. Higginbotham said.
In the black population in the study, with data combined over visit and time of day, travoprost usage resulted in a mean IOP of 17.2 mm Hg, vs. 18.6 mm Hg for latanoprost. Among patients of other racial or ethnic groups the mean IOP was 18.5 mm Hg in patients taking travoprost vs. 18.6 mm Hg in patients taking latanoprost.
Dr. Higginbotham noted that the Ocular Hypertension Treatment Study, which randomized 1,600 patients with ocular hypertension to treatment or no treatment, showed that corneas were thinner in black patients compared to white patients. “Could this [difference in travoprost’s effect] be related to corneal thickness? Who really knows?” she said.
“Since the data did not reveal any superiority in efficacy when analyzed according to iris color, there are obviously other factors besides pigment that give you this kind of outcome,” she continued. “So I think with all these, we’ve got something we will talk about for the subsequent study to perhaps look at corneal thickness to see if that might be one powerful factor that might separate out this effect,” Dr. Higginbotham said.
Breakout of IOP in blacks and
non-blacks using Travatan across all visits.
More effective in blacks
The responder analysis of the studies showed that in black patients a mean IOP of less than 22 mm Hg was achieved in 96% of travoprost patients, 86% of latanoprost patients and 75% of timolol patients.
In patients of other racial or ethnic groups, the responder analysis showed that a mean IOP of less than 22 mm Hg was achieved in 89% of travoprost patients, 87% of latanoprost patients and 84% of timolol patients.
“The subgroup analysis I think is extremely interesting. This particular compound appears to work more effectively among African-Americans. The reasons for this have yet to be delineated,” Dr. Higginbotham said.
For Your Information:
- Eve Higginbotham, MD, professor and chair of the department of ophthalmology at the University of Maryland, Baltimore, can be reached at 419 West Redwood, Ste. 580, Baltimore, MA 21201; (410) 328-5929.