This article is more than 5 years old. Information may no longer be current.
Nepafenac potentiates prostaglandin analogs in POAG
Click Here to Manage Email Alerts
The ocular nonsteroidal anti-inflammatory nepafenac aided the efficacy of prostaglandin analogs, according to a study recently published in the Journal of Glaucoma.
Özyol and colleagues conducted a single-center, prospective clinical study to analyze the influence of nepafenac on intraocular pressure in patients with primary open-angle glaucoma.
Researchers evaluated 35 POAG patients who were prescribed travoprost, latanoprost or bimatoprost. Participants were given nepafenac 0.1% (Nevanac, Alcon Laboratories) in their right eyes and placebo (Tears Naturale II, Alcon Laboratories) in their left eyes three times a day for 7 days, in conjunction with the prostaglandin analogs.
Researchers measured IOP at baseline at various times of the day, as well as throughout the medication period and up to 7 days after the treatment was discontinued.
Results showed that during the treatment period, eyes in the nepafenac group saw a greater decrease in mean IOP than the placebo group. Additionally, 1 day after discontinuing treatment, mean IOP for both groups became similar.
Researchers reported no significant differences in mean IOP changes between the three prostaglandins.
"Our findings suggest that nepafenac potentiates the IOP-lowering effect of prostaglandin analogs in POAG patients," the authors wrote. "Nepafenac and amfenac rapidly inhibit prostaglandin biosynthesis and may increase the bioavailability of all ocular prostanoid receptors that determine the enhancement of the IOP-lowering effect of prostaglandin analogs. In our study, lower IOP levels observed within 1 hour after the administration show the rapid effect of nepafenac on prostaglandin receptors."
Disclosure: The authors have no relevant financial disclosures.
Perspective
Back to Top
Blair Lonsberry, OD, FAAO
In this study, the authors demonstrate that the addition of a topical nonsteroidal anti-inflammatory drug (nepafenac) results in an increased intraocular pressure-lowering effect from three different prostaglandin analog medications in a group of patients with primary open-angle glaucoma.
One of the major limitations of this study is the small sample size in each of the treatment groups (N of 11 to 12) and the short follow-up time (7 days). The IOP-lowering effect was equivalent for each of the prostaglandin analogs and occurs rapidly after the administration of the NSAID. It is proposed that nepafenac inhibits the biosynthesis of prostaglandins and makes available more potential binding sites for the prostaglandin analogs, potentiating their IOP lowering effects.
The study demonstrates the importance of understanding the potential interactions of concurrently administered topical medications on the IOP-lowering effect of prostaglandin analogs and potentially all topically administered medications. It is unlikely that practitioners will begin to prescribe long-term use of a topical NSAID to help potentiate the IOP-lowering effect of prostaglandin analogs, but it is important to recognize the potential influence that other medications have on each other.
Click Here to Manage Email Alerts