PURPOSE: Glaucoma is a neurodegenerative disease that leads to progressive vision loss. Management of glaucoma typically focuses on reducing intraocular pressure (IOP) using topical ocular hypotensive medications as first line therapy. Latanoprostene Bunod 0.024% (LBN) is indicated for IOP reduction in patients with open-angle glaucoma (OAG) and ocular hypertension (OHT). Previous real-world studies have shown significant clinical benefit through IOP reduction in OAG patients that switched from other topical IOP reducing medications to LBN. However, the real-world impact of switching to LBN in patients with varying baseline IOP and glaucoma severity has not yet been fully quantified. This study aims to characterize the impact of switching to LBN in these patients with varying baseline IOP and glaucoma severity

METHODS: Patients (≥18 years) with OAG/OHT and ≥1 LBN claim following a prior topical therapy between July 2017 and June 2023 were identified using the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) linked to a third-party commercial insurance claims database. The date of first LBN prescription was defined as the index date with preceding 6- months as baseline and following 6-months as the follow-up period. Patients at baseline were stratified based on (1) IOP (≤18 mmHg, 19-20 mmHg, ≥21 mmHg) and (2) Glaucoma severity (mild, moderate, severe and unspecified). Change in IOP at baseline and after switching to LBN were compared any time between day 30-180 after the first LBN-claim. Statistical significance was set at p<0.05.

RESULTS: A total of 833 patients with OAG/OHT met the study criteria that switched to LBN from prior topical therapy. Based on baseline IOP, 399 (47.9%) patients had IOP ≤18 mmHg, 163 (19.6%) had IOP 19-20 mmHg and 271 (32.5%) had IOP ≥21 mmHg. The mean (SD) reduction in IOP in the ≤18 mmHg cohort was 0.8 (3.2) mmHg, in the 19-20 mmHg cohort was 2.6 (3.5) mmHg reduction and in the ≥21 mmHg cohort was 5.9 (5.6) mmHg reduction from baseline to 30-180 days post-first LBN. Based on baseline glaucoma severity, 278 (33.4%) patients were mild OAG, 236 (28.3%) were moderate OAG and 148 (17.8%) were severe OAG. The mean (SD) reduction in IOP in the mild OAG cohort was 2.8 (4.6) mmHg, in the moderate cohort was 2.7 (4.3) mmHg reduction and in the severe cohort was 2.4 (4.5) mmHg. All unadjusted analyses for mean reduction in IOP yielded a P-value of <0.001. In patients with baseline IOP of 19-20 mmHg and those with ≥21 mmHg, ~55% of patients and ~76% patients had an IOP reduction of ≥3 mmHg, respectively.

CONCLUSION: Significant reduction in IOP across OAG/OHT patients with varying baseline IOP and glaucoma severity shows the clinical benefit of switching to LBN in real-world clinical practice. These findings corroborate prior real-world findings that showed 2.8 mmHg reduction in IOP after switching to LBN.