Treatment with preservative-free medication can improve patient outcomes

When it comes to medical treatment for glaucoma, available evidence demonstrates that use of a preservative-free medication has the potential to positively impact side effects, quality of life, and self-reported adherence. In addition, findings from a model simulation suggest treatment with a preservative-free medication can reduce overall costs and improve patient outcomes, said Norbert Pfeiffer MD at ESCRS Glaucoma Day 2016. Reviewing the consequences of preservative-free treatments, Dr Pfeiffer, Mainz University, Germany, noted that benzalkonium chloride (BAK) can cause side effects such as allergy and ocular surface disease that likely can reduce quality of life. He also presented findings from an open-label study in which patients experiencing adverse events while using a preservative-containing prostaglandin analogue benefited with a reduction in their signs and symptoms after switching to a preservative-free agent. The patients also reported reduced interference with their quality of life after the switch. Another study found that patients using IOP-lowering medications without preservatives had a higher self-reported medication adherence rate than their counterparts using preservative-containing medications. Analyses from a model simulating 10-year outcomes of patients being initiated on IOP-lowering treatment found that the mean total cost of treatment was higher when starting with a BAK-containing prostaglandin analogue compared with one formulated with an alternative, gentler preservative. The model also predicted differences favouring use of the latter medication regarding proportions of patients remaining on their first- or second-line treatment, needing laser or surgical intervention, and progressing to more advanced disease.