Safety and efficacy of travoprost solution for the treatment of elevated intraocular pressure

Abstract

Travoprost is a prostaglandin analogue widely used for reducing intraocular pressure (IOP) in patients affected with glaucoma and ocular hypertension. It exerts its ocular hypotensive effect through the prostaglandin FP receptors, located in the ciliary muscle and the trabecular meshwork. Several studies have shown that topical administration of travoprost induces a mean IOP reduction ranging from 25% to 32%, and sustained throughout the 24-hour cycle. When compared with timolol, travoprost is more effective at reducing IOP, while generally no difference has been found in the head-to-head comparison with other prostaglandin analogues. The fixed combination of travoprost and timolol has demonstrated a hypotensive efficacy comparable to the concomitant administration of the two drugs. Recently, a new preservative-free formulation of travoprost 0.004% has been marketed for reducing tolerability-related problems in subjects affected with ocular surface disease. Low rates of topical and systemic adverse reactions, strong ocular hypotensive efficacy, and once-a-day dosing make travoprost a first-line treatment for patients affected with elevated IOP.

Keywords: glaucoma; ocular hypertension; prostaglandin analogue.

Figure 1

Travoprost chemical structure. Notes: (A) Travoprost prodrug. (B) Travoprost free acid, after hydrolysis of isopropyl ester in carbon-1 position.

Figure 2

Mean 24-hour, diurnal, and nocturnal intraocular pressure in a cohort of primary open-angle glaucoma patients treated with travoprost monotherapy and followed-up for 5 years. Note: Reprinted with permission from Riva I, Katsanos A, Floriani I, et al. Long-term 24-hour intraocular pressure control with travoprost monotherapy in patients with primary open-angle glaucoma. J Glaucoma. 2014;23(8):535–540.

Figure 3

Mean intraocular pressure with latanoprost, travoprost, and bimatoprost at baseline and after 12 weeks of treatment in a cohort of primary open-angle glaucoma and ocular hypertension patients. Note: Reprinted from Am J Ophthalmol. 135(5):688–703. Parrish RK, Palmberg P, Sheu WP, XLT Study Group. A comparison of latanoprost, bimatoprost, and travoprost in patients with elevated intraocular pressure: a 12-week, randomized, masked-evaluator multicenter study. Copyright 2003 with permission from Elsevier.

Figure 4

Heterochromia due to unilateral therapy with travoprost in right eye.