The following is a summary of “Adherence and Persistence on Prostaglandin Analogues for Glaucoma: A Systematic Review and Meta-Analysis,” published in the March 2025 issue of American Journal of Ophthalmology by Baudouin et al. 

Researchers conducted a retrospective study to analyze adherence and persistence patterns with prostaglandin analogues (PGAs) in glaucoma treatment to better understand real-world treatment behavior.  

They updated a 2011 systematic literature review (SLR) through electronic searches in MEDLINE, Embase, and the Cochrane Database of Systematic Reviews (CDSR), supplemented by manual searches of SLR and meta-analysis (MA) bibliographies. Observational studies in adults with glaucoma treated with PGAs that reported objective adherence or persistence measures were included. Adherence for any/unspecified PGA was assessed using mean medication possession ratio/proportion of days covered (MPR/PDC), with values >80% indicating good adherence. Therapy duration was defined as the period from initial prescription to discontinuation or therapy switch.  

The results showed that the SLR included 50 publications from 47 unique studies involving 9,61,000 individuals. The MA incorporated all but 4 studies that lacked age distribution data. At Year 1, 44% (95% CI: 31–58%) of individuals using any/unspecified prostaglandin analogue (PGA) were adherent. The mean medication possession ratio/proportion of days covered (MPR/PDC) was 54% (95% CI: 38–75%) at Year 1 and increased to 60% (95% CI: 39–94%) at Year 2. The proportion of individuals who remained persistent on any/unspecified PGA declined from 75% (95% CI: 66–85%) at Month 6 to 31% (95% CI: 12–55%) at Year 3. A smaller decrease was noted between Year 1 (56%; 95% CI: 45–66%) and Year 2 (53%; 95% CI: 45–62%), with a greater decline between Years 2 and 3. The mean duration of therapy was 315.7 days (95% CI: 190.0–441.5 days).  

Investigators concluded the observed decline in patient adherence to PGAs over time emphasized the potential benefits of procedural glaucoma treatments that bypass daily medication use. 

Source: ajo.com/article/S0002-9394(25)00137-0/abstract