Briefing Note: tafluprost (Saflutan)

SMC accepted tafluprost preservative-free eye drops for the reduction of elevated intraocular pressure in open-angle glaucoma (group of eye conditions that affect vision) and ocular hypertension (pressure in the eye is higher than normal) as monotherapy (in patients who would benefit from preservative-free eye drops who are insufficiently responsive to first-line therapy, or who are intolerant or contraindicated to first-line therapy) or as adjunctive therapy to beta blockers.

• Tafluprost is restricted for use in patients who cannot tolerate the currently available prostaglandin preparations due to proven sensitivity to the preservative benzalkonium chloride.
• Glaucoma tends to affect two in every 100 people over the age of 40.1 Open-angle glaucoma is the most common type of glaucoma. It is caused by blockages in the drainage tubes within the eye, preventing eye fluid from draining properly and then pressure builds up damaging the optic nerves and the nerve fibres from the retina (sensory tissue that lines the back of the eye). In the early stages, there are few symptoms because it develops very slowly but in its later stages, the patient will develop tunnel vision (loss of outer field of vision) and eventually become blind. A person with ocular hypertension is at greater risk of developing glaucoma so it is important that it is detected early and monitored carefully.
• Lowering of intraocular pressure remains the only effective long-term strategy against loss of sight. Tafluprost is a new prostaglandin which reduces intraocular pressure by increasing the aqueous outflow through the network of drainage tubes. One drop of tafluprost is given in the evening.
• Preservative-free tafluprost is as good at lowering intraocular pressure as a preserved formulation of tafluprost. Preserved tafluprost is as effective as a beta-blocker in reducing intraocular pressure but did not show equivalence to a prostaglandin comparator.
• The side effects were similar for preservative-free tafluprost and a preserved formulation of tafluprost, with the most common side effect being ocular/conjunctival hyperaemia (severe redness and irritation of the eyes). In a study comparing tafluprost with a betablocker, more side effects were reported in the tafluprost group but more patients discontinued in the beta blocker group.
• SMC accepted tafluprost for use because it was considered to have similar efficacy and a slightly lower drug cost than some comparators and is cheaper when compared with some other preservative-free agents.