Switching to Brimonidine/Ripasudil Fixed Combination from Brimonidine + Ripasudil

Kenji Inoue; Minako Shiokawa; Shiho Kunimatsu-Sanuki; Goji Tomita; Kyoko Ishida

doi:10.2147/OPTH.S446962

Switching to Brimonidine/Ripasudil Fixed Combination from Brimonidine + Ripasudil

Clin Ophthalmol. 2024 Feb 7:18:423-430. doi: 10.2147/OPTH.S446962. eCollection 2024.

Authors

Kenji Inoue¹, Minako Shiokawa¹, Shiho Kunimatsu-Sanuki², Goji Tomita^{1

3}, Kyoko Ishida³

Affiliations

¹ Inouye Eye Hospital, Tokyo, Japan.
² Nishikasai Inouye Eye Hospital, Tokyo, Japan.
³ Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan.

Abstract

Purpose: A fixed-combination eye drop has several advantages over combination therapy, however, the intraocular pressure (IOP)-lowering efficacy and safety of the newly available brimonidine + ripasudil fixed-combination (BRFC) eye drops after switching from brimonidine + ripasudil is yet to be established. Therefore, this study aimed to retrospectively investigate the 6-month safety, usability, and IOP-lowering efficacy of BRFC switched from brimonidine and ripasudil.

Patients and methods: Overall, 69 patients with primary open-angle glaucoma (69 eyes) receiving brimonidine + ripasudil were enrolled in this study. Brimonidine + ripasudil was discontinued, and treatment was switched to BRFC without a washout period. The IOP was compared before and at 3 and 6 months after switching to BRFC. The side effects, discontinued cases, and usability (a questionnaire survey) were also investigated.

Results: The IOP was not significantly different after switching to BRFC (15.1 ± 3.3 mmHg at baseline, 15.9 ± 3.6 mmHg after 3 months, and 14.6 ± 3.3 mmHg after 6 months). Adverse reactions occurred in four patients (5.8%): allergic conjunctivitis, two patients; irritation, one patient; and blurred vision, one patient. Treatment was discontinued in five (7.2%) patients owing to allergic conjunctivitis, two patients; increased IOP, two patients; and blurred vision, one patient. In the questionnaire survey, 68 patients with eye pain, 67 with itching, 64 with conjunctival hyperemia, 64 with irritation, and 62 with blurred vision reported no change or improved conditions. Additionally, in response to the question regarding preferences for pre-treatment and fixed combinations, 14 participants (20.2%) favored pre-treatment, while 53 (76.8%) preferred fixed combinations.

Conclusion: The IOP was maintained for 6 months, with satisfactory safety and comfort of use, with BRFC switched from brimonidine and ripasudil.

Keywords: adverse reactions; brimonidine/ripasudil; fixed combination; intraocular pressure; switching; usability.

Grants and funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.