The following is a summary of “Comparison of allergy prevalence using brinzolamide 1.0% / brimonidine 0.2% fixed combination with and without β-blocker in glaucoma patients: a retrospective cohort study,” published in the July 2024 issue of Ophthalmology by Park et al.

Glaucoma management frequently requires multiple medications, which can result in low adherence and side effects, whereas fixed-dose combinations seek to enhance adherence and minimize AEs compared to standard treatments.

Researchers conducted a retrospective study comparing the prevalence and clinical features of ocular allergy in patients with glaucoma using brinzolamide 1.0%/brimonidine 0.2% fixed combination (BBFC), both with and without a concurrent β-blocker.

They assessed 176 patients using a β-blocker concurrently, while 96 patients were not. The prevalence, types, and timing of allergies were compared between the groups using and not using a concurrent β-blocker. Kaplan–Meier survival analysis assessed and classified the Ocular allergies.

The results showed that patients who used BBFC had a lower prevalence of allergies (10.23% vs. 15.63% (P=0.193) but experienced later (15.92 months vs. 6.26 months on average (P=0.04). Half of the group developed allergies within 12.5 months, as indicated by Meier survival analysis, and the need to stop using BBFC steadily increased over the following 36 months. Conversely, allergies occurred more frequently and earlier (within 3.3 months) in the non-concurrent beta-blocker group. The group also observed a faster discontinuation rate of BBFC within the first 6 months. A significant difference was also shown in the types of allergies between the groups (P=0.015). On average, blepharoconjunctivitis, papillary conjunctivitis, and follicular conjunctivitis occurred after 12.52, 9.53, and 13.23 months, respectively. Follicular conjunctivitis typically appeared later than papillary conjunctivitis (P=0.042). In the group using concurrent β-blockers, follicular conjunctivitis was the most common type of allergy (61.1%), while in the group not using β-blockers, papillary conjunctivitis was the most prevalent (66.7%).

Investigators concluded that the concurrent use of β-blockers with BBFC reduces allergy prevalence, postpones allergy onset, and mainly leads to follicular conjunctivitis, supporting prolonged treatment and informing patient management and adherence.

Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03550-2