PURPOSE: Latanoprostene bunod (LBN) 0.024% ophthalmic solution is indicated for the reduction of intraocular pressure in patients with open-angle glaucoma (OAG) and ocular hypertension (OHT). The presence of concomitant dry eye disease (DED) may adversely affect adherence to glaucoma therapies, potentially leading to poorer outcomes. This study aimed to evaluate real- world LBN treatment patterns including adherence, persistence, and discontinuation and to compare outcomes between patients with OAG with and without comorbid incident DED.

METHODS: A retrospective analysis of 100% Medicare Fee-for-Service (Parts A/B/D) claims data was conducted to identify patients aged ≥65 years with OAG, with or without incident DED, who received an LBN prescription between January 2017 and June 2020. Index date was defined as the earliest DED diagnosis or treatment occurring within six months following OAG identification. Patients initiating LBN after the index date were followed for 12 months. Adherence was assessed using the Proportion of Days Covered (PDC), measured through the end of the supply period, with PDC ≥0.80 indicating adherence. Switching was defined as initiation of an alternative therapy during the final days of LBN supply or within a 60-day gap. Discontinuation was defined as a gap of at least 60 days after the end of LBN supply.

RESULTS: A total of 912 patients met all inclusion criteria. The cohort was predominantly female (55%) and White (79%), with a mean (SD) age of 77.3 (8.1) years. Among patients with DED (n=194), the most common subtype was aqueous-deficient DED (47.4%), followed by mixed forms (34.0%), evaporative (9.8%), and inflammatory (8.9%). The distribution of OAG/OHT severity was comparable between cohorts. In patients without DED (n=718), disease severity was categorized as severe (19.1%), moderate (19.6%), mild (14.1%), and OHT (9.5%). Among patients with comorbid DED, severity was distributed as severe (17.5%), moderate (14.9%), mild (10.3%), and OHT (8.2%). Among the comorbid DED cohort, mean (SD) PDC for LBN was 0.75 (0.24), with 45.1% of patients achieving adherence (PDC ≥0.80). Approximately 44.5% (n=406) of patients discontinued treatment, and among these, 62.1% (n=252) subsequently restarted LBN. Patients without DED had a mean (SD) PDC of 0.73 (0.24), which was not significantly different from patients with DED, who had a mean (SD) PDC of 0.75 (0.24) (p>0.05).

CONCLUSION: Average adherence to LBN was approximately 75%, with nearly half of patients meeting the ≥80% adherence threshold. Adherence rates were comparable between patients with and without comorbid DED, suggesting similar tolerability of LBN irrespective of DED status. Notably, a substantial proportion of patients who discontinued therapy later resumed treatment. These findings underscore the durability, tolerability, and real-world clinical utility of LBN in older patients with OAG/OHT, including those with concomitant DED.