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Travoprost

Klassificering: B

Preparat: Bondulc, DuoTrav, IZBA, Travatan, Travatan Z, Travoprost Medical Valley, Travoprost Sandoz, Travoprost STADA, Travoprost/Timolol Medical Valley, Travoprost/Timolol STADA

ATC kod: S01ED51, S01EE04

Substanser: travoprost

Sammanfattning

Det saknas publicerade kontrollerade studier om skillnader mellan könen avseende effekt för travoprost ögondroppar.
 
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.

Additional information

Pharmacokinetics and dosing

According to the manufacturer’s documentation to FDA, the pharmacokinetic parameters appeared to be similar in men and women. As the plasma concentrations were very low, results should be interpreted with great caution [10]. No sex differentiation in dosing has been recommended [11].

Effects

No studies with a clinically relevant sex analysis regarding the effects travoprost eyedrops have been found.

Adverse effects

In an observer masked, open-label prospective study Japanese patients with primary open angle glaucoma (10 men, 22 women) were treated with travoprost during 6 months. The side effect “deepening of the upper eyelid sulcus“ (DUES) was equally common in men and women [12].

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Other information

In a population-based survey study including a medical examination in 4744 Australians, 2.3% were previously diagnosed with ocular hypertension or open angle glaucoma (52 male, 56 female). The proportion reporting a history of glaucoma surgery or treatment with glaucoma medication was similar in men and women [1].

In a study from the US nearly half of the individuals who had filled one glaucoma prescription discontinued the treatment within six months. Among glaucoma patients aged 40-49 years, living in the Southeast region of the US and being a woman were factors associated with discontinuation [2].

General differences between men and women with glaucomaIn a randomized clinical trial of normal-tension glaucoma patients, an untreated subset of patients (61 men, 99 women) was analyzed regarding risk factors for (a high) progression rate of visual field loss. The time to measurable decrease in visual field was shorter in women than in men (1849 vs. 2356 days and the speed of deterioration was higher in women than in men (0.47 vs. 0.23 decibels per year). Migraine and optic disk hemorrhage were other risk factors for an increased progression rate (OR 2.58 and 2.72, respectively). According to the authors, it could be wise to treat women with migraine or optic disk hemorrhage aggressively as they are at a higher risk of faster progression than others [3].An eye examination of a West Greenland Eskimos population > 40 years old (162 men, 182 women) aimed at detecting primary angle-closure glaucoma (PACG) showed a higher prevalence in women than in men (age-group 60-69: 5% in men, 15% in women and age-group 70+: 3% in men, 27% in women) [4]. Measurements of the right eyes (155 men, 156 women) showed that the limbal chamber depth (LCD), as well as the axial chamber depth (ACD) was lower in women than in men [5].In a population based study in the Netherlands it was noted that women who were postmenopausal before the age of 45 had a higher risk of open-angle glaucoma (odds ratio 2.6) compared to those who were older at menopause (odds ratio for open angle glaucoma of 1.1) [6]. A study of endothelial nitric oxide synthase gene variants found an association with open angle glaucoma which might explain this [7]. Studies on the effect of hormonal replacement therapy (HRT) are lacking [8].In a retrospective study, glaucoma patients (64 men, 59 women) underwent selective laser trabeculoplasty (SLT). The intra ocular pressure (IOP) lowering efficacy of SLT was equal in men and women and regardless of type, or absence of glaucoma medication at 6 months post-laser [9].

Försäljning på recept

Fler kvinnor än män hämtade ut ögondroppar innehållande travoprost (ATC-kod S01EE04) på recept i Sverige år 2015, totalt 8 891 kvinnor och 7 384 män. Det motsvarar 1,8 respektive 1,5 patienter per tusen invånare. Andelen som hämtat ut läkemedel ökade med stigande ålder hos båda könen. Totalt sett var ögondroppar innehållande travoprost 1,2 gånger vanligare hos kvinnor [13].

Fler kvinnor än män hämtade ut ögondroppar innehållande timolol i kombination (ATC-kod S01ED51) på recept i Sverige år 2015, totalt 38 434 kvinnor och 33 818 män. Det motsvarar 7,9 respektive 6,9 personer per tusen invånare. Andelen som hämtat ut läkemedel ökade med stigande ålder hos båda könen [13]. ATC-koden innehåller timololkombinationer med bimatoprost, brinzolamid, brimonidin, dorzolamid, latanoprost, pilokarpin, travoprost, tafluprost. Kombinationen timolol/travoprost utgör 21 % av den totala försäljningen i denna ATC-kod [14].

Uppdaterat: 2019-02-26

Litteratursökningsdatum: 2015-12-02

Referenser

  1. Weih LM, Van Newkirk M, McCarty CA, Taylor HR. Patterns of glaucoma medication use in urban and rural Victoria. Aust N Z J Ophthalmol. 1998;26 Suppl 1:S12-5. PubMed
  2. Nordstrom BL, Friedman DS, Mozaffari E, Quigley HA, Walker AM. Persistence and adherence with topical glaucoma therapy. Am J Ophthalmol. 2005;140:598-606. PubMed
  3. Drance S, Anderson DR, Schulzer M, Collaborative Normal-Tension Glaucoma Study Group. Risk factors for progression of visual field abnormalities in normal-tension glaucoma. Am J Ophthalmol. 2001;131:699-708. PubMed
  4. Alsbirk PH. Early detection of primary angle-closure glaucoma Limbal and axial chamber depth screening in a high risk population (Greenland Eskimos). Acta Ophthalmol (Copenh). 1988;66:556-64. PubMed
  5. Alsbirk PH. Limbal and axial chamber depth variations A population study in Eskimos. Acta Ophthalmol (Copenh). 1986;64:593-600. PubMed
  6. Higginbotham EJ. Does sex matter in glaucoma?. Arch Ophthalmol. 2004;122:374-5. PubMed
  7. Kang JH, Wiggs JL, Rosner BA, Hankinson SE, Abdrabou W, Fan BJ et al. Endothelial nitric oxide synthase gene variants and primary open-angle glaucoma: interactions with sex and postmenopausal hormone use. Invest Ophthalmol Vis Sci. 2010;51:971-9. PubMed
  8. Vajaranant TS, Nayak S, Wilensky JT, Joslin CE. Gender and glaucoma: what we know and what we need to know. Curr Opin Ophthalmol. 2010;21:91-9. PubMed
  9. Singh D, Coote MA, O'Hare F, Walland MJ, Ghosh S, Xie J et al. Topical prostaglandin analogues do not affect selective laser trabeculoplasty outcomes. Eye (Lond). 2009;23:2194-9. PubMed
  10. Food and Drug Administration (FDA). Clinical Pharmacology and Biopharmaceutics Review - TRAVATAN (travoprost). Food and Drug Administration [www]. [updated 2000-07-07, cited 2016-01-08]. länk
  11. Travatan (travoprost). Summary of Product Characteristics. European Medicines Agency (EMA); 2015.
  12. Aihara M, Shirato S, Sakata R. Incidence of deepening of the upper eyelid sulcus after switching from latanoprost to bimatoprost. Jpn J Ophthalmol. 2011;55:600-4. PubMed
  13. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-04-05.] länk
  14. Conicse. Stockholm: eHälsomyndigheten. 2015 [cited 2016-03-23.] länk

Författare: Maria Enghag

Faktagranskat av: Mia von Euler

Godkänt av: Karin Schenck-Gustafsson