한국인 녹내장 환자에서 브린졸라미드 1.0%/브리모니딘 0.2% 복합제제의 알레르기 임상양상 = Clinical Characteristics of Allergy to a Brinzolamide 1.0%/Brimonidine 0.2% Fixed Combination in Korean Glaucoma Patients

다국어 초록 (Multilingual Abstract)

Purpose: We describe the clinical aspects of allergy to a brinzolamide 1.0%/brimonidine 0.2% fixed combination (BBFC) in Korean patients with glaucoma.
Methods: The medical records of 117 glaucoma patients treated with BBFC were retrospectively analyzed in terms of sex, age, glaucoma type, follow-up period after prescription of eyedrops, number of eyedrop preparations used, allergy onset, and clinical characteristics.
Results: The incidence of ocular allergy during BBFC use was 12.8%. Allergy developed after an average of 8.58 months (range, 0.93-25.80 months); half of all allergies were evident within the first 5 months. The most common type of allergy was follicular conjunctivitis (53.4%), followed by papillary conjunctivitis and blepharoconjunctivitis. Systemic side-effects and eye discomfort (0.09%) were largely confined to non-allergic patients.
Conclusions: An understanding of the clinical pattern of BBFC allergy in Korean glaucoma patients could facilitate treatment compliance and patients’ education.

국문 초록 (Abstract)

목적: 한국 녹내장 환자에서 브린졸라미드 1.0%/브리모니딘 0.2% 고정복합제제(brinzolamide 1.0%/brimonidine 0.2% fixed combination, BBFC)의 알레르기 임상양상을 알아보고자 하였다.
대상과 방법: 녹내장으로 진단 받고 BBFC를 사용 중인 환자 117명을 대상으로 후향적 의무기록을 분석하였다. 성별, 나이, 녹내장 형태, 점안약 사용 후 경과 관찰 기간, 병용 약제 수, 알레르기 발생 시기 및 임상특징을 조사하였다.
결과: BBFC 치료 후 알레르기 발생률은 12.8%로 평균 8.58개월(범위: 0.93-25.80개월)에 발생하였으며 알레르기의 절반은 초기 5개월 내에 발생하였다. BBFC에 의한 알레르기는 여포결막염 형태가 53.4%로 가장 많았고, 유두결막염, 눈꺼풀결막염 순이었다. 알레르기를 제외한 전신 부작용과 눈 불편감은 0.09%로 주로 비알레르기군에서 관찰되었다.
결론: 한국 녹내장 환자에서 BBFC 관련 알레르기 임상양상의 파악은 환자 교육 및 점안 순응도 향상에 도움을 줄 것으로 기대한다.

참고문헌 (Reference)

1 김인태, "한국인 정상안압녹내장에서 브린졸라미드 1%와 브리모니딘 0.2% 혼합제제의 임상 효과" 대한안과학회 59 (59): 561-568, 2018

2 신현욱, "정상안압녹내장에서 브린졸라미드/브리모니딘 혼합제제의 효과" 대한안과학회 57 (57): 1619-1624, 2016

3 박한석, "정상안압녹내장에서 브린졸라미드 1%와 티몰롤 0.5% 혼합제제의 효과" 대한안과학회 55 (55): 1056-1063, 2014

4 한종욱, "전신 알레르기 질환과 브리모니딘 점안으로 인한 알레르기결막염의 관계" 대한안과학회 60 (60): 233-238, 2019

5 박은정, "녹내장에서 브리모니딘/티몰롤 복합제제와 0.15% 브리모니딘 사용 시 알레르기 발생률의 비교" 대한안과학회 59 (59): 451-458, 2018

6 Sung KR, "Vision-related quality of life in Korean glaucoma patients" 26 : 159-165, 2017

7 Patil PM, "Unequal accumulation of adrenergic drugs by pigmented and nonpigmented iris" 78 : 470-477, 1974

8 Aung T, "Twice-daily brinzolamide/brimonidine fixed combination versus brinzolamide or brimonidine in open-angle glaucoma or ocular hypertension" 121 : 2348-2355, 2014

9 Katz LJ, "Twelve-month evaluation of brimonidine-purite versus brimonidine in patiens with glaucoma or ocular hypertension" 11 : 119-126, 2002

10 Taniguchi T, "The potential systemic effect of topically applied β-blockers in glaucoma therapy" 8 : 55-58, 1997

11 Collaborative Normal-Tension Glaucoma Study Group, "The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma" 126 : 498-505, 1998

12 Kass MA, "The Ocular Hypertension Treatment Study : a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma" 120 : 701-713, 2002

13 Whitson JT, "Six-month results from a phase III randomized trial of fixed-combination brinzolamide 1%+ brimonidine 0.2% versus brinzolamide or brimonidine monotherapy in glaucoma or ocular hypertension" 7 : 1053-1060, 2013

14 Alvarado JA, "Reduced ocular allergy with fixed-combination 0.2%brimonidine-0.5% timolol" 125 : 717-718, 2007

15 Nguyen QH, "Phase 3 randomized 3-month trial with an ongoing 3-month safety extension of fixedcombination brinzolamide 1%/brimonidine 0.2%" 29 : 290-297, 2013

16 Goldenberg MM, "Pharmaceutical approval update" 38 : 323-324, 2013

17 Melanmed A, "Ongoing clinical assessment of the safety profile and efficacy of brimonidine compared with timolol : year-three results" 22 : 103-111, 2000

18 Zhang X, "Ocular surface disease and glaucoma medications : a clinical approach" 45 : 11-18, 2019

19 Hwang HB, "Histopathologic analysis of conjunctival lymphoproliferative disease after topical brimonidine use" 35 : 503-511, 2019

20 Realini T, "Fixed-combination brinzolamide 1%/brimonidine 0.2% vs monotherapy with brinzolamide or brimonidine in patients with open-angle glaucoma or ocular hypertension: results of a pooled analysis of two phase 3studies" 27 : 841-847, 2013

21 Manni G, "Demographic and clinical factors associated with development of brimonidine tartrate 0.2%-induced ocular allergy" 13 : 163-167, 2004

22 Acheampong AA, "Comparative ocular pharmacokinetics of brimonidine after a single dose application to the eyes of albino and pigmented rabbits" 23 : 708-712, 1995

23 Butler P, "Clinical experience with the long-term use of 1% apraclonidine. Incidence of allergic reactions" 113 : 293-296, 1995

24 Katz LJ, "Brimonidine tartrate 0.2% twice daily vs timolol 0.5%twice-daily: 1-year results in glaucoma patients. Brimonidine Study Group" 127 : 20-26, 1999

25 Kim CY, "Brimonidine 0.2% versus brimonidine Purite 0.15% in Asian ocular hypertension" 23 : 481-486, 2007

26 Friedman DS, "An evidence-based assessment of risk factors for the progression of ocular hypertension and glaucoma" 138 (138): S19-S31, 2004

27 Bondeau P, "Allergic reactions to brimonidine in patients treated for glaucoma" 37 : 21-26, 2002

28 Kim CY, "A path analysis of effects of patients'underlying conditions, treatment satisfaction, and adherence on quality of life among Korea glaucoma patients" 28 : 785-789, 2019

29 Schuman JS, "A 1-year study of brimonidine twice daily in glaucoma and ocular hypertension : a controlled, randomized, multicenter clinical trial" 115 : 847-852, 1997

30 Duffin RM, "2.5% v 10% phenylephrine in maintaining mydriasis during cataract surgery" 101 : 1903-1906, 1983