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Introduction <p>Glaucoma is a chronic progressive disease and the leading cause of blindness, particularly among older individuals. Treatment persistence with intraocular pressure (IOP)-lowering therapy is essential to avoid visual impairment, although data on persistence with combination eye-drop therapy are lacking. The objective of this study was to evaluate treatment persistence with combination eye-drop therapy in Japanese patients with glaucoma or ocular hypertension.</p> Methods <p>This longitudinal cohort study analysed anonymised insurance claims data from the DeSC database. Adults (≥ 18 years) with glaucoma or ocular hypertension who initiated IOP-lowering therapy within the same month as their diagnosis between June 2020 and May 2023 were included. The primary outcomes were: (1) treatment persistence among patients who initiated carteolol/latanoprost-based combination therapy (research question [RQ] 1); (2) persistence according to the number of bottles and active IOP-lowering ingredients (RQ2); (3) persistence according to the number of bottles of eye drops (RQ3); and (4) persistence according to concomitant use of different IOP-lowering drugs (RQ6).</p> Results <p>Among patients who initiated carteolol/latanoprost (RQ1 cohort; <i>n</i> = 28,560), the 360-day persistence rates were highest with concomitant brimonidine/brinzolamide (23.0%) and lowest with ripasudil (16.5%). The median duration of persistence was longer with concomitant brimonidine or brimonidine/brinzolamide versus concomitant brinzolamide, ripasudil or dorzolamide (148 vs 130, 120 and 117 days, respectively). Persistence also increased with increasing number of active IOP-lowering ingredients (RQ2 cohort; two-bottles, <i>n</i> = 160,481; three-bottles, <i>n</i> = 48,994) but declined with increasing number of bottles of eye drops (RQ3 cohort; <i>n</i> = 188,676). Combination therapy with a β-blocker plus a prostaglandin F2α receptor agonist showed a trend towards having the longest persistence duration, while β-blocker plus carbonic anhydrase inhibitor regimens showed a trend towards the shortest duration (RQ6).</p> Conclusion <p>These findings suggest that treatment persistence with combination eye-drop therapy in Japanese patients with glaucoma or ocular hypertension may differ depending on the IOP-lowering regimen.</p>

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Treatment Persistence with Combination Eye Drops for Glaucoma: A Longitudinal Analysis Using Japanese Medical Claims Data

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月15日

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  • Kenji Kashiwagi,
  • Miyuki Matsukawa,
  • Rikiya Toda,
  • Kana Okamoto,
  • Daisaku Michikami

摘要

Introduction

Glaucoma is a chronic progressive disease and the leading cause of blindness, particularly among older individuals. Treatment persistence with intraocular pressure (IOP)-lowering therapy is essential to avoid visual impairment, although data on persistence with combination eye-drop therapy are lacking. The objective of this study was to evaluate treatment persistence with combination eye-drop therapy in Japanese patients with glaucoma or ocular hypertension.

Methods

This longitudinal cohort study analysed anonymised insurance claims data from the DeSC database. Adults (≥ 18 years) with glaucoma or ocular hypertension who initiated IOP-lowering therapy within the same month as their diagnosis between June 2020 and May 2023 were included. The primary outcomes were: (1) treatment persistence among patients who initiated carteolol/latanoprost-based combination therapy (research question [RQ] 1); (2) persistence according to the number of bottles and active IOP-lowering ingredients (RQ2); (3) persistence according to the number of bottles of eye drops (RQ3); and (4) persistence according to concomitant use of different IOP-lowering drugs (RQ6).

Results

Among patients who initiated carteolol/latanoprost (RQ1 cohort; n = 28,560), the 360-day persistence rates were highest with concomitant brimonidine/brinzolamide (23.0%) and lowest with ripasudil (16.5%). The median duration of persistence was longer with concomitant brimonidine or brimonidine/brinzolamide versus concomitant brinzolamide, ripasudil or dorzolamide (148 vs 130, 120 and 117 days, respectively). Persistence also increased with increasing number of active IOP-lowering ingredients (RQ2 cohort; two-bottles, n = 160,481; three-bottles, n = 48,994) but declined with increasing number of bottles of eye drops (RQ3 cohort; n = 188,676). Combination therapy with a β-blocker plus a prostaglandin F2α receptor agonist showed a trend towards having the longest persistence duration, while β-blocker plus carbonic anhydrase inhibitor regimens showed a trend towards the shortest duration (RQ6).

Conclusion

These findings suggest that treatment persistence with combination eye-drop therapy in Japanese patients with glaucoma or ocular hypertension may differ depending on the IOP-lowering regimen.