IOP-lowering regimens that rely on use of several topical drugs may experience diminishing returns with each additional agent and, in turn, cause an increased clinical and economic burden for glaucoma patients, new research published in the Journal of Glaucoma suggests.

The retrospective analysis included claims from patients diagnosed with open-angle glaucoma and ocular hypertension using one to four topical glaucoma medications of different drug classes. They were assessed in four subgroups based on number of meds: Group 1 (one drug), Group 2 (two drugs), Group 3 (three drugs) and Group 4 (four drugs).

After 12 months of follow-up, the researchers found that 84% of patients were no longer following their initial treatment regimen. Treatment changes were especially frequent among patients with high initial drug counts.

During the same time, 7.8%, 12.2%, 17.2% and 22.6% of patients in Groups 1-4, respectively, had augmented treatment either with the addition of another drop, a laser or surgery. At 24 months, 12.6%, 18.5%, 25.9% and 33.7% of patients in each group, respectively, needed more treatment.

Additionally, the researchers noted that costs rose incrementally as the number of medications increased for all four treatment groups.

Patel AR, Schwartz GF, Campbell JH, et al. Economic and clinical burden associated with intensification of glaucoma topical therapy: a US claims-based analysis. J Glaucoma. October 29, 2020. [Epub ahead of print].