Topical prostaglandin fixed combinations in UK primary care: observational study using data from the health improvement network

Abstract

Purpose

To describe the use of 3 prostaglandin/timolol fixed combinations (FCs) in UK primary care, to summarize characteristics of recipients, and to assess 12-month persistence.

Methods

This retrospective cohort study included first-time recipients of latanoprost/timolol FC, bimatoprost/timolol FC, or travoprost/timolol FC treated between April 1, 2007, and November 30, 2008, identified in The Health Improvement Network database, a large database of anonymized longitudinal electronic medical records of patients treated in UK primary care. Eligible patients were ≥18 years old at the index date (date of first prescription). Persistence, defined as a gap ≤60 days between consecutive prescriptions, was assessed through 12 months post-index for each cohort (Cox proportional hazards models).

Results

A total of 2,015 patients were included: latanoprost/timolol FC, n=898 (44.6%); bimatoprost/timolol FC, n=733 (36.4%); travoprost/timolol FC, n=384 (19.1%). The mean age was approximately 72 years across cohorts (p=0.792). Glaucoma was the diagnosis for >90% of patients in each cohort. Twelve-month persistence was similar across treatments: latanoprost/timolol FC: 38.2%; bimatoprost/timolol FC: 38.6%; travoprost/timolol FC: 38.3% (p=0.985). Mean time to therapy change for nonpersistent patients was also similar: 143.3±89.8, 151.0±87.9, and 151.8±87.7 days, respectively (p=0.095). Among persistent patients, additional therapy was prescribed for 36.2%, 41.7%, and 41.5% of patients, respectively. Among nonpersistent patients, 64.0%, 70.4%, and 69.2%, respectively, restarted the index therapy.

Conclusions

The largest proportion of first-time recipients of prostaglandin/beta-blocker FC products treated in UK primary care was prescribed latanoprost/timolol FC. Twelve-month persistence was similar (<40%) across the 3 FCs evaluated.

Keywords

Bimatoprost Fixed combination Latanoprost Persistence Timolol Travoprost

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