Background
Methods
Study design
Data source
Patients
Study endpoints
Statistics
Sample size
Statistical methods
Results
Patient disposition and baseline characteristics
Characteristic | Fixed combination n = 364 | Unfixed combination n = 1039 | Overall N = 1403 |
---|---|---|---|
Age, mean (SD) | 49.62 (10.72) | 49.76 (10.03) | 49.72 (10.21) |
Age, n (%) | |||
20–34 years | 26 (7.14) | 72 (6.93) | 98 (6.99) |
35–49 years | 169 (46.43) | 454 (43.70) | 623 (44.40) |
50–64 years | 137 (37.64) | 448 (43.12) | 585 (41.70) |
≥ 65 years | 32 (8.79) | 65 (6.26) | 97 (6.91) |
Gender, n (%) | |||
Male | 215 (59.07) | 594 (57.17) | 809 (57.66) |
Female | 149 (40.93) | 445 (42.83) | 594 (42.34) |
Systolic blood pressure, mmHg, mean (SD) | 122.4 (15.77) n = 251 | 124.76 (17.06) n = 788 | 124.19 (16.78) n = 1039 |
Diastolic blood pressure, mmHg, mean (SD) | 76.28 (11.57) | 76.72 (11.58) | 76.62 (11.57) |
Smoking status, n (%) | |||
Non-smoker | 188 (51.65) | 555 (53.42) | 743 (52.96) |
Current smoker | 53 (14.56) | 140 (13.47) | 193 (13.76) |
Missing/unknown | 123 (33.79) | 344 (33.11) | 467 (33.29) |
Type of glaucoma (ICD-10 code), n (%) | |||
Glaucoma suspect (H40.0) | 85 (23.35) | 278 (26.76) | 363 (25.87) |
Primary open-angle glaucoma (H40.1) | 57 (15.66) | 231 (22.23) | 288 (20.53) |
Glaucoma secondary to eye inflammation (H40.4) | 3 (0.82) | 4 (0.38) | 7 (0.5) |
Glaucoma secondary to other eye disorders (H40.5) | 21 (5.77) | 27 (2.60) | 48 (3.42) |
Glaucoma secondary to drugs (H40.6) | 1 (0.27) | 6 (0.58) | 7 (0.5) |
Unspecified glaucoma (H40.9) | 197 (54.12) | 493 (47.45) | 690 (49.18) |
Hospital size, n (%) | |||
≤ 19 hospital beds | 235 (64.56) | 741 (71.32) | 976 (69.57) |
20–99 hospital beds | 9 (2.47) | 23 (2.21) | 32 (2.28) |
100–199 hospital beds | 8 (2.2) | 21 (2.02) | 29 (2.07) |
200–299 hospital beds | 10 (2.75) | 25 (2.41) | 35 (2.49) |
300–499 hospital beds | 22 (6.04) | 54 (5.20) | 76 (5.42) |
≥ 500 hospital beds | 80 (21.98) | 175 (16.84) | 255 (18.18) |
Duration of second-line treatment (months), mean (SD) | 13.4 (17.05) | 12.25 (14.90) | 12.55 (15.49) |
Duration of persistence with second-line treatment
Factors associated with second-line treatment modification
Variable | Unadjusted HR (95% CI) | P value | Adjusted HR (95% CI) | P value |
---|---|---|---|---|
Combination drug | ||||
With fixed combination drug | 1.065 (0.913, 1.243) | 0.4205 | 0.988 (0.811, 1.203) | 0.9016 |
Without fixed combination drug | Referent | Referent | ||
Age (years) | 1.000 (0.994, 1.007) | 0.9078 | 0.993 (0.984, 1.003) | 0.1634 |
Gender | ||||
Male | Referent | Referent | ||
Female | 1.025 (0.893, 1.177) | 0.722 | 1.048 (0.863, 1.273) | 0.6338 |
Smoking status | ||||
Non-smoker | Referent | Referent | ||
Current smoker | 1.221 (0.996, 1.496) | 0.0546 | 1.216 (0.982, 1.506) | 0.0729 |
Type of glaucoma (ICD-10 code) | ||||
Glaucoma suspect (H40.0) | Referent | Referent | ||
Primary open angle glaucoma (H40.1) | 0.800 (0.649, 0.986) | 0.0361 | 0.834 (0.643, 1.082) | 0.1719 |
Secondary glaucoma (H40.3 to H40.6) | 1.678 (1.231, 2.288) | 0.0011 | 1.512 (1.003, 2.280) | 0.0484 |
Unspecified glaucoma (H40.9) | 1.006 (0.853, 1.187) | 0.9403 | 1.070 (0.868, 1.319) | 0.5243 |
Hospital size | ||||
≤ 19 hospital beds | Referent | Referent | ||
20–499 hospital beds | 0.912 (0.734, 1.135) | 0.4098 | 0.879 (0.667, 1.158) | 0.3582 |
≥ 500 hospital beds | 0.852 (0.717, 1.013) | 0.0702 | 0.859 (0.687, 1.074) | 0.1832 |
Systolic blood pressure (mmHg) | 1.005 (1, 1.009) | 0.0618 | 1.002 (0.994, 1.011) | 0.5637 |
Diastolic blood pressure (mmHg) | 1.007 (1, 1.014) | 0.0595 | 1.005 (0.993, 1.017) | 0.4169 |
Duration of first-line treatment (months) | 0.987 (0.982, 0.993) | < 0.0001 | 0.988 (0.981, 0.994) | 0.0002 |
Number of drug categories | ||||||
---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | ||
First-line treatment, n (%) | Unfixed combination (n = 1320) | 1218 (92.27) | 89 (6.74) | 11 (0.83) | 2 (0.15) | – |
Fixed combination (n = 83) | 63 (75.90) | 18 (21.69) | 2 (2.41) | – | – | |
Total (N = 1403) | 1281 (91.30) | 107 (7.63) | 13 (0.93) | 2 (0.14) | – | |
Second-line treatment, n (%) | Unfixed combination (n = 364) | 136 (13.09) | 812 (78.15) | 84 (8.08) | 6 (0.58) | 1 (0.10) |
Fixed combination (n = 1039) | 4 (1.10) | 306 (84.07) | 47 (12.91) | 6 (1.65) | 1 (0.27) | |
Total (N = 1403) | 140 (9.98) | 1118 (79.69) | 131 (9.34) | 12 (0.86) | 2 (0.14) |
Second-line combination drug | Unadjusted HR (95% CI) | P value | Adjusted HR (95% CI) | P value |
---|---|---|---|---|
Fixed combination | ||||
PGA/BB | ||||
Latanoprost/ Timolol maleate | 1.377 (0.959 1.977) | 0.0832 | 1.322 (0.83 2.106) | 0.2397 |
Travoprost/ Timolol maleate | 0.670 (0.477 0.941) | 0.0208 | 0.578 (0.377 0.886) | 0.0119 |
CAI/BB | ||||
Brinzolamide/ Timolol maleate | 0.852 (0.499 1.453) | 0.5561 | 0.802 (0.394 1.631) | 0.5418 |
Dorzolamide hydrochloride/ Timolol maleate | 0.998 (0.751 1.326) | 0.9867 | 0.862 (0.6 1.238) | 0.4211 |
Unfixed combination | ||||
PGA | 0.527 (0.404 0.687) | < 0.0001 | 0.549 (0.39 0.771) | 0.0006 |
CAI | 3.077 (1.721 5.502) | 0.0002 | 3.603 (1.77 7.334) | 0.0004 |
BB | 1.867 (1.388 2.513) | < 0.0001 | 2.014 (1.386 2.926) | 0.0002 |
Othersa | Reference | Reference | ||
PGA and BB | 0.717 (0.553 0.929) | 0.0118 | 0.788 (0.57 1.091) | 0.1508 |
PGA and CAI | 0.704 (0.485 1.021) | 0.0642 | 0.81 (0.513 1.28) | 0.3678 |
CAI and BB | 1.181 (0.806 1.731) | 0.3936 | 1.082 (0.671 1.744) | 0.7461 |
PGA and BB and CAI | 0.846 (0.496 1.444) | 0.5406 | 0.871 (0.441 1.722) | 0.692 |
Treatment patterns
Treatment duration
Treatment Pattern | |
---|---|
Patients switched from first-line treatment, n | 182 |
Duration of the first-line treatment, months (mean ± SD) | |
Fixed combination | 8.19 ± 8.98 |
Unfixed combination | 16.94 ± 18.05 |
Duration of first-line treatment, months (mean ± SD) | |
PGA | 12.63 ± 14.88 |
BB | 13.9 ± 16.79 |
CAI | 5.14 ± 7.20 |
α-blocker | 6.71 ± 5.91 |
α-agonist | 4.36 ± 6.54 |
Others | 17 ± 22.28 |
PGA/BB | 8.47 ± 9.39 |
CAI/BB | 5.2 ± 6.83 |
Of those switched to fixed combination as second-line, n (%) | n = 104 |
Switched to another drug in the third-line | 22 (21.15) |
Added on another drug in the third-line | 18 (17.31) |
Dropped the combination therapy | 25 (24.04) |
Stayed on the combination therapy | 39 (37.50) |
Of those switched to unfixed combination as second-line, n (%) | n = 78 |
Switched to another drug in the third-line | 16 (20.51) |
Added on another drug in the third-line | 15 (19.23) |
Dropped the combination therapy | 21 (26.92) |
Stayed on the combination therapy | 26 (33.33) |
Duration of second-line treatment (added on in the third-line), months (mean ± SD) | |
PGA | 8.08 ± 4.37 |
BB | 7.02 ± 4.55 |
CAI | 6.52 ± 4.94 |
α-blocker | 7.00 ± 5.77 |
α-agonist | 5.58 ± 4.60 |
Others | 4.86 ± 3.63 |
PGA/BB | 6.90 ± 4.61 |
CAI/BB | 7.03 ± 4.46 |
Duration of second-line treatment (switched in the third-line), month (mean ± SD) | |
PGA | 7.08 ± 4.54 |
BB | 7.39 ± 4.38 |
CAI | 4.40 ± 2.88 |
α-blocker | 10.00 ± 2.00 |
α-agonist | 7.00 ± 7.07 |
Othersa | 4.75 ± 4.86 |
PGA/BB | 7.14 ± 4.64 |
CAI/BB | 2.92 ± 2.78 |