Comparative analysis of hyperaemia rate between preservative-free latanoprost and preserved prostaglandin eyedrops. An adjusted indirect comparison meta-analysis

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For the evaluation of hyperaemia, differences in measurement process could exist between the trial in terms of definition, procedure, follow-up, etc. These differences make the comparison of absolute rate or proportion of patients with hyperaemia between the trial inappropriate and potentially confused by these differences. To avoid this problem, meta-analysis does not pool absolute proportion but odds ratio (or risk ratio). Odds ratios make implicit adjustment for this kind of difference by using the value observed in the control group as reference. The technique of “adjusted indirect comparisons” are based on this principle and were used to assess tolerability of a preservative free latanoprost compared to preserved prostaglandins for the treatment of open-angle glaucoma (OAG) and ocular hypertension (OH)


The meta-analysis was performed according to a protocol established before the start of the literature search and data analysis. It was conducted and reported according to the recent PRISMA statement. The main endpoints were intraocular pressure (IOP) and hyperaemia


Twenty-one studies were included. The risk of hyperaemia was statistically significantly lower with preservative-free latanoprost than with polyquaternium-1-travoprost (OR [95%CI]: 0.24, sofzia-travoprost (0.37 ), BAK-bimatoprost 0.03% (0.18 ]), BAK-bimatoprost 0.01% (0.27 ), BAK-tafluprost (0.18 ), BAK-travoprost (0.25 ) and BAK-latanoprost (0.52 [


The risk of hyperaemia was found statistically significantly lower with preservative free latanoprost than with all the preserved prostaglandin analogs comprised in the metaanalysis.


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