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The glaucoma intensive treatment study : interim results from an ongoing longitudinal randomized clinical trial

The glaucoma intensive treatment study : interim results from an ongoing longitudinal randomized clinical trial


Title: The glaucoma intensive treatment study : interim results from an ongoing longitudinal randomized clinical trial
Author: Bengtsson, Boel
Lindén, Christina
Heijl, Anders
Andersson-Geimer, Sabina
Aspberg, Johan
Jóhannesson, Gauti
Date: 2021
Language: English
Scope:
Department: Faculty of Medicine
Series: Acta Ophthalmologica; ()
ISSN: 1755-375X
DOI: https://doi.org/10.1111/aos.14978
Subject: javascript:void(0);; Gláka; Lyf; Prófanir; Samanburðarrannsóknir; Augnsjúkdómar; drug trial; glaucoma; progression; RCT; visual field; Ophthalmology
URI: https://hdl.handle.net/20.500.11815/2833

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Citation:

Bengtsson , B , Lindén , C , Heijl , A , Andersson-Geimer , S , Aspberg , J & Jóhannesson , G 2021 , ' The glaucoma intensive treatment study : interim results from an ongoing longitudinal randomized clinical trial ' , Acta Ophthalmologica . https://doi.org/10.1111/aos.14978

Abstract:

Purpose: The aim of the study was to determine the perimetric rate of glaucoma progression in the ongoing Glaucoma Intensive Treatment Study (GITS) after 3 years of follow-up. Design: This is a randomized, two-centre, prospective open-labelled treatment trial for open-angle glaucoma (OAG). Participants: The participants of this study were treatment-naive patients with newly diagnosed OAG, aged 46–78 years, with early to moderate glaucomatous visual field loss scheduled to be followed for 5 years within the study. Methods: Patients were randomized to initial treatment with either topical monotherapy or with an intensive approach using drugs from three different classes, plus 360° laser trabeculoplasty. Changes in treatment were allowed. Standard automated perimetry and tonometry were performed and side-effects documented. All results are presented using intention-to-treat analysis. Results: A total of 242 patients were randomized. After 3 years of follow-up, eight patients were lost to follow-up, six of whom were deceased. The median untreated baseline intraocular pressure (IOP) was 24 mmHg in both arms. The median IOP was almost constant over the 3 years of follow-up: ≈17 mmHg in the mono-arm and ≈14 mmHg in the multi-treatment arm. Treatment was intensified in 42% of the mono-treated patients and in 7% of the multi-treated patients. Treatment was reduced in 13% of the multi-treated patients. The median perimetric rate of progression was −0.5%/year in the mono-treated group and −0.1%/year in the multi-treated group (p = 0.03). Conclusion: The rate of disease progression was significantly slower in the multi-treated patients than in the mono-treated patients. Further follow-up will show whether this difference is sustained over time.

Description:

Funding text Financial support was provided through regional agreements between Lund University and Skane Regional Council (ALF), and between Umea University and V€asterbotten County Council and also by grants from the Swedish Society for medical research, Knut and Alice Wallenbergs foundation, Cronqvist foundation, € Ogonfonden, Swedish medical society foundation, Foundation for visually impaired in former Malm€ohus county, King Gustav V and Queen Victoria’s freemason foundation, foundations and donations administered by Skane University Hospital, Crown Princess Margareta´s foundation, Margit and Kjell Stolz Foundation, Herman J€arnhardt foundation, Ingrid Nordmark’s foundation and Insamlingsstiftelserna vid Umea universitet. None of the supporting organizations had any role in the design or conduct of the research. Publisher Copyright: © 2021 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

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