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Glaucoma drugs’ efficacy can differ as primary, adjunctive therapies
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LAS VEGAS — Physicians cannot assume that when one glaucoma drug is added to another it will be as effective as when it is used as a primary agent, said Steven T. Simmons, MD.
“One can’t add one medication and then expect it to work as well as it does as a primary agent,” Dr. Simmons said here at the Ocular Surgery News Symposium, Glaucoma: Improving Your Odds. “And you can’t assume that a medication that is effective when added to A will also be effective when added to B.”
The goal of adjunctive therapy is to achieve an additional 15% pressure reduction, Dr. Simmons said. Also, it is hoped that the two medications will work synergistically because each time a therapeutic agent is added there are additional safety concerns, he said.
Clinical trials have shown that adjunctive therapy gives patients the benefits of achieving and sustaining low target pressures, he said.
Dr. Simmons recommended adding another medication or performing argon laser trabeculoplasty when IOP remains uncontrolled on monotherapy. He also recommended that physicians perform monocular trials when adding a new drug to a patient’s regimen.
Other recommendations include considering the long-term efficacy, safety and tolerability of the adjunctive medications, and individualizing treatment to the patient’s needs.