Pharmacoepidemiology of the antiglaucoma drugs in Brazil from 2012 to 2018

Abstract Purpose: To outline the epidemiological profile of clinical treatments for glaucoma provided by the Brazilian Unified Health System (SUS, acronym in Portuguese) between January 2012 and December 2018. Methods: A quantitative and descriptive study was conducted using available data based on the outpatient information system from SUS (SIA/SUS, acronym in Portuguese). The variables were monocular treatment with first, second, and third-line drugs; monocular treatment with combinations of two drugs and three drugs from different lines; binocular treatment with first, second, and third-line drugs; and binocular treatment with combinations of two drugs and three drugs from different lines. Results: During the analysis period, the prevalence of clinical therapies for glaucoma increased from 2012 to 2017 and decreased from 2017 to 2018. Of the clinically treated patients, 96% were carriers of binocular glaucoma. Among the regions of Brazil, the Northeast had the highest prevalence of binocular glaucoma (about 60% of the number of cases), and the most common therapy was combinations of two drugs from different lines. The Southeast region had the highest concentration of monocular glaucoma (53% of cases), and the predominant therapy was combinations of three drugs from different lines. The Midwest region had the lowest prevalence of monocular-treatments for glaucoma (less than 6%). Conclusion: In Brazil, the highest number of treatments offered by the public health system was in the Northeast and Southeast regions. There is a high national prevalence and potential for the morbidity of this disease. Therefore, it is necessary to strengthen programs aimed at early diagnosis and appropriate treatment to reduce adverse outcomes.

摘要
目的：概述2012年1月至2018年12月期间，巴西统一卫生系统（葡萄牙语缩写为SUS）提供的抗青光眼临床治疗的流行病学特征。
方法：本研究为定量描述性研究，采用巴西统一卫生系统门诊信息系统（葡萄牙语缩写为SIA/SUS）的可用数据开展分析。纳入的分析变量包括：单眼一线、二线及三线抗青光眼药物治疗；单眼不同层级抗青光眼药物联合（两种药物联合、三种药物联合）治疗；双眼一线、二线及三线抗青光眼药物治疗；双眼不同层级抗青光眼药物联合（两种药物联合、三种药物联合）治疗。
结果：分析周期内，抗青光眼临床治疗的患病率于2012年至2017年间呈上升趋势，2017年至2018年有所回落。在接受临床治疗的患者中，96%为双眼青光眼患者。巴西各区域中，东北部地区双眼青光眼患病率最高（约占总病例数的60%），最常见的治疗方案为不同层级的两种抗青光眼药物联合治疗；东南部地区单眼青光眼病例占比最高（53%），主流治疗方案为不同层级的三种抗青光眼药物联合治疗；中西部地区单眼青光眼治疗的患病率最低（不足6%）。
结论：巴西公立卫生系统提供的抗青光眼治疗服务量最高的区域为东北部与东南部。全国范围内该病患病率较高，且存在较高的疾病发病风险。因此，有必要加强针对早期诊断与规范治疗的相关项目，以降低不良预后的发生。