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Abstract #27441 Published in IGR 12-4
A meta-analysis of the peer-reviewed literature on topical prostaglandin analogues: Demonstration of a tool for making evidence-based decisions for managed care formularies
Kymes S; Burk C; Feinman T; Williams J; Hollander DJournal of Managed Care Pharmacy 2010; 16: 515
BACKGROUND: Systematic reviews relying on meta-analytic techniques to create summary statistics are considered the nullgold standardnull for synthesizing evidence to support clinical decision making. However, the process for conducting such studies is extremely time consuming and labor intensive, putting such work outside the capability of most formulary managers. We describe a collaboration with an online provider of systematic review services and software that eases this process. OBJECTIVE: To conduct a systematic review of the efficacy of topical prostaglandin analogues (PGAs) in reducing intraocular pressure (IOP) in people with primary open angle glaucoma (POAG). METHODS: Using Doctor Evidence software, we conducted a review and data extraction from peer-reviewed literature through September 2009. Candidate studies were limited to randomized, controlled, comparative studies of at least 3 months duration assessing latanoprost, bimatoprost, and/or travoprost in patients with POAG, ocular hypertension, or normotensive glaucoma. Primary endpoints were mean IOP lowering and 24-hour IOP lowering. Summary estimates were created using a random effects model. The Q chi-square test was used to assess statistical heterogeniety. RESULTS: Fourteen studies satisfied inclusion criteria and were analyzed. On average, a 1 mm Hg greater IOP lowering was seen in bimatoprost relative to latanoprost based on 24-hour IOP lowering (P < 0.001). No statistical difference was observed in 24-hour IOP lowering between latanoprost and travoprost (P = 0.95). Findings were similar to previously published meta-analyses on topical PGAs. CONCLUSIONS: Transparent evidence-based decisions require the use of systematic reviews for evidence synthesization. We have demonstrated the effectiveness of a commercial service that substantially eases the process of conducting such reviews.
S. Kymes. Washington University, School of Medicine, 660 S. Euclid Ave., St. LouisUnited States. Kymes@vrcc.wustl.edu
Classification:
11.4 Prostaglandins (Part of: 11 Medical treatment)
