LA COMBINACION DE LATANOPROST Y TIMOLOL EN PROPORCION FIJA ES EFICAZ PARA TRATAR EL GLAUCOMA DE ANGULO ABIERTO

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La formulación en proporción fija de latanoprost, un análogo de las prostaglandinas, y timolol, un bloqueante de los receptores adrenérgicos beta, es eficaz para reducir la presión intraocular en pacientes con glaucoma de ángulo abierto, y presenta la ventaja adicional de la simpleza de su posología (1 gota, 1 vez por día) y buena tolerabilidad.
feldman9.jpg Autor:
Robert m Feldman
Columnista Experto de SIIC
Artículos publicados por Robert m Feldman
Recepción del artículo
22 de Septiembre, 2006
Aprobación
10 de Octubre, 2006
Primera edición
30 de Julio, 2007
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
El glaucoma, la segunda causa más frecuente de amaurosis en todo el mundo, es una enfermedad crónica, incurable. El objetivo principal del tratamiento médico es preservar la visión mediante la reducción de los valores de la presión intraocular (PIO). Actualmente, se utiliza una variedad de agentes que producen hipotensión ocular, pero numerosos pacientes requieren más de un fármaco para lograr la disminución suficiente de la PIO. Esas combinaciones a menudo implican esquemas complejos de administración, con la consiguiente dificultad para su cumplimiento por parte de los pacientes; tales inconvenientes pueden obviarse con el uso de formulaciones combinadas en proporción preestablecida. La solución oftálmica que contiene la combinación en proporción fija (CPF) de latanoprost (una prostaglandina) al 0.005% y timolol (un betabloqueante) al 0.5%, cuya posología es 1 gota, 1 vez por día, combina dos mecanismos de acción para disminuir la PIO. El latanoprost actúa fundamentalemente a través del incremento del flujo de salida uveoescleral, mientras que el timolol reduce la velocidad de producción de humor acuoso por el epitelio ciliar. Algunos ensayos clínicos demostraron que dicha CPF es tan eficaz para disminuir la PIO como el uso paralelo de sus componentes, y que su efecto es equiparable o superior al de otras combinaciones, en proporción fija o no. Además, posee un perfil de seguridad favorable, equivalente al de sus principios activos individuales. Debido a la conveniencia de la administración 1 sola vez al día, la CPF descrita constituye una opción segura y eficaz para los individuos que no pueden lograr el descenso adecuado de la PIO mediante la monoterapia.

Palabras clave
Latanoprost, Timolol, Combinación fija, Glaucoma, Hipertensión ocular


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Abstract
Glaucoma, the second leading cause of blindness worldwide, is a chronic, incurable disease. The principal aim of medical treatment is to preserve vision through reduction in levels of intraocular pressure (IOP). A variety of ocular hypotensive agents are currently in use, with many patients requiring more than 1 drug to achieve sufficient lowering of IOP. These combinations often entail complex scheduling, with resultant difficulties in patient compliance that may be obviated through the use of fixed combination (FC) formulations. The FC ophthalmic solution containing 0.005% latanoprost, a prostaglandin, and 0.5% timolol, a β-blocker, administered as one drop once-daily, combines two mechanisms of action to reduce IOP. Latanoprost acts principally through increasing uveoscleral outflow, while timolol decreases the rate of production of aqueous humor by the ciliary epithelium. Clinical trials have demonstrated that FC latanoprost/timolol is as effective in lowering IOP as the concomitant use of its two constituents, and is equivalent or superior to other available fixed or unfixed combinations. Moreover, it has a favorable safety profile, equivalent to that of its individual components. Given the convenience of once-daily dosing, this FC formulation provides a safe and effective option for patients who cannot achieve adequate lowering of IOP through monotherapy.

Key words
Latanoprost, Timolol, Fixed-combination, Glaucoma, Ocular hypertension


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Especialidades
Principal: Oftalmología
Relacionadas: Farmacología, Medicina Farmacéutica, Medicina Interna



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Enviar correspondencia a:
Robert M Feldman, The Hermann Eye Center, TX 77030, 6411 Fannin, 7th Floor, Jones, Houston, EE.UU.
Patrocinio y reconocimiento:
Pfizer Inc. proporcionó el apoyo financiero para la realización de este trabajo.
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