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\title{Systematic Review of Clinical and Economic Evidence for Primary Open-Angle Glaucoma Therapy with Tafluprost vs Travoprost}
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             \author[1]{Shoyusuf F.  Shodmanov}

             \author[2]{Shakhnoza Z.  Umarova}

             \author[3]{Zoya R.  Usmanova}

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\date{\small \em Received: 1 January 1970 Accepted: 1 January 1970 Published: 1 January 1970}

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\begin{abstract}
        


According to WHO, the number of patients with glaucoma in the world ranges from 60.5 to 105 million people, and the number of such patients is also predicted to increase to 80 million. Out of 28 million blind people in the world almost one in five lost their sight due to glaucoma. The aim of this research is to conduct a systematic review of the clinical and economic evidence for the treatment of primary open-angle glaucoma with Tafluprost vs Travoprost.Methods: PubMed interface, MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, NICE databases were used as main searching sources of this study.

\end{abstract}


\keywords{primary open-angle glaucoma, systematic review, clinical efficacy, economic efficiency, PubMed.}

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\let\tabcellsep& 	 	 		 
\section[{Introduction}]{Introduction}\par
laucoma is one of the leading causes of blindness, it is a chronic disease that visual area is reduced permanently because of optic nerve damage.\par
According to the World Health Organization, total number of patients with glaucoma in the world ranges from 60.5 to 105 million people, and increasing this number is predicted to 80 million. There is significant an increase the role of glaucoma among primary disability causes, the nosological structure increased up to 20\% in the last decade. According to the statistics of WHO, more than 28 million people in the world faced to the blindness, it means almost one in five has lost sight cause of glaucoma.\par
In majority of patients (about 86\%) suffer from glaucoma for a long time, the disease passes into a more severe stage. In this regard, this disease is not only purely medical issue, but also it is social problems.\par
The research questions were asked in discussions with healthcare providers, clinical professionals, and other healthcare stakeholders.\par
The aim of the study was to conduct a systematic review of the clinical and economic evidence for the therapy of primary open-angle glaucoma (POAG) with Tafluprost vsTravoprost. 
\section[{II.}]{II.} 
\section[{Materials and Methods}]{Materials and Methods}\par
A literature search was performed on PubMed interface and used for the MEDLINE database, in addition, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and NICE were used to search for relevant literature. As an input of medical librarians, search strategy was developed by using appropriate keywords and control variables. In order to obtain relevant information on the prevalence of glaucoma and other important evidence, we searched the gray literature on various health websites. The formulation of the PICO concept is very critical because it facilitates the therapeutic question and directly addresses the relevant issues, defining the key concepts that should be the focus of our economic analysis of health care.\par
The acronym PICO is presented in the following In order to evaluate clinical outcomes feedback was requested from several associations involved in glaucoma therapy in Tashkent city. We turned to an ophthalmologist, nurses who regularly diagnose glaucoma in patients. The role of the clinical expert was to critique our requests, provide information regarding the patient management algorithm, review the clinical review plan and medical technology assessment.\par
Economic literature search was conducted to cover studies conducted from inception to the date of the search. PubMed interface was used for the Medline database, and the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and NICE were used to search relevant literature. By input from medical librarians, a search strategy was developed with relevant keywords and control variables, with an economic filter set. In order to obtain relevant information on the current prevalence of glaucoma and other important evidence, we conducted a gray literature search on various health websites.\par
Titles and abstracts of the papers were carefully reviewed, for those studies that should meet the eligibility criteria, we purchased articles with full content and completed further evaluation for eligibility. 
\section[{III.}]{III.} 
\section[{Results and Discussions}]{Results and Discussions}\par
A clinical efficacy literature search identified 434 studies, including those obtained from database searches and additional sources. After removing duplicates and irrelevant studies assessed by title selection, 285 citations remained. Finally, only 2 articles meet the inclusion criteria. To report the studies, we found in systematic reviews, we developed the PRISMA Chart (Preferred Reporting Items for systematic reviews and meta-analyses) (Figure  {\ref 1}). Two single arm cohort studies were selected because they met the inclusion criteria. The first study examined IOP adjustment and visual area imperfection movement over a 3-year period while adjusting Travoprost eye drops monotherapy in patients with POAG \hyperref[b1]{[2]}. A second cohort study examined the effects of Tafluprost eye drops on IOP changes, visual area progression, safety, and side effects in patients with POAG \hyperref[b2]{[3]}.\par
We were unable to find studies examining mortality due to glaucoma. In addition, there is no any research conducted to investigate patients with advanced and end-stage glaucoma treated with our interventions.  Overall, both Travoprost and Tafluprost were found to be effective interventions for lowering intraocular pressure in patients with POAG. Innoueetal. (2012) in their randomized control trial showed the effectiveness of Travoprosteye drops in reducing IOP, which in the long term was 16.1-36.6\%, while the reduction in IOP by 21.9±14.0\% with the introduction of Tafluprost in patients with POAG. There have been no reports of visual area impairment due to long-term use of Tafluprost and Travoprost eye drops. Significant differences in average and standard deviation of the model were not observed before and after treatment with follow-up 3 years in both analyzed studies. It can be seen that when comparing the efficacy of the two interventions, Travoprost had a slightly higher efficacy in lowering IOP than Tafluprost among patients with POAG \hyperref[b1]{[2,}\hyperref[b2]{3]}.\par
A systematic review identified one study evaluating the economic effectiveness of Travoprost and Tafluprost in the treatment of pre-intervention openangle glaucoma in previously untreated 65-year-old patients.\par
Intraocular pressure, visual area characteristics, and patient value of drugs are derived from published retrospective clinical reviews and randomized control trials with a follow-up period of 20 years. Average wholesale prices were taken to calculate drug price data for both social and direct eye care costs. As recommended by the Health and Medicine Cost Efficiency Panel, all costs and benefits assessed by the patient were discounted annually at a rate of 3\%. The results showed that each anti-intervention drug has demonstrated clinical and economic effectiveness. Travoprost scored 1.92 QALYs (15\% improvement in quality of life) over a 20-year period, and Tafluprost scored a slightly higher score of 1.99 QALYs  {\ref (14.2\%}     \begin{figure}[htbp]
\noindent\textbf{1} \par 
\begin{longtable}{P{0.85\textwidth}}
below:\end{longtable} \par
  {\small\itshape [Note: FShoyusuf F.]} 
\caption{\label{tab_0}table 1}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{1} \par 
\begin{longtable}{P{0.015454545454545453\textwidth}P{0.29082644628099175\textwidth}P{0.0014049586776859503\textwidth}P{0.015454545454545453\textwidth}P{0.5268595041322315\textwidth}}
Acronym\tabcellsep \multicolumn{3}{l}{General definition}\tabcellsep Acceptance of the model\\
P\tabcellsep \multicolumn{2}{l}{Population (patients)}\tabcellsep \tabcellsep Patients over 40 with open-angle glaucoma\\
\tabcellsep \multicolumn{3}{l}{Intervention (Intervention -an}\tabcellsep Tafluprost is a prostaglandin analogue eye drops\\
I\tabcellsep \multicolumn{3}{l}{alternative method of treatment}\tabcellsep used to prevent the progression of open-angle\\
\tabcellsep (relatively new)\tabcellsep \tabcellsep \tabcellsep glaucoma by lowering intraocular pressure(IOP).\\
\tabcellsep Comparator\tabcellsep \tabcellsep \tabcellsep Travoprost is a prostaglandin analogue eye drops\\
C\tabcellsep (Comparator\tabcellsep -\tabcellsep traditional\tabcellsep used to prevent the progression of open-angle\\
\tabcellsep treatment)\tabcellsep \tabcellsep \tabcellsep glaucoma by lowering IOP.\\
O\tabcellsep \multicolumn{3}{l}{Outcome efficiency (The result is profitability) of economic}\tabcellsep Lowering IOP and delaying the progression of glaucoma\end{longtable} \par
 
\caption{\label{tab_1}Table 1 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{2} \par 
\begin{longtable}{P{0.08964421855146125\textwidth}P{0.012960609911054638\textwidth}P{0.37261753494282085\textwidth}P{0.06480304955527319\textwidth}P{0.20304955527318932\textwidth}P{0.028081321473951714\textwidth}P{0.033481575603557814\textwidth}P{0.045362134688691234\textwidth}}
\tabcellsep \tabcellsep \multicolumn{2}{l}{Records identified through database}\tabcellsep \multicolumn{3}{l}{Additional records identified through}\tabcellsep \\
Identification\tabcellsep \tabcellsep \multicolumn{5}{l}{searching (n=45) Records after duplicates removed other sources (n = 20)}\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{(n =50)}\tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep \tabcellsep \multicolumn{2}{l}{Recordsscreened}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep \tabcellsep (n = 50)\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
Screening\tabcellsep \tabcellsep \multicolumn{2}{l}{Full-text articles assessed for eligibility (n = 10)}\tabcellsep \multicolumn{3}{l}{Full-text articles excluded(n=9): ? Pre-clinical}\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{? Laser therapy}\tabcellsep \tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep ? Abstracts\tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \multicolumn{4}{l}{? Articleisnotrelated to economicefficiency}\\
Included\tabcellsep \tabcellsep \multicolumn{2}{l}{Studies included in reviews (n = 1)}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
Authors, year\tabcellsep Country\tabcellsep Purpose of the study\tabcellsep Randomized groups\tabcellsep Basic mean deviation(MD)\tabcellsep Patients(men /women)\tabcellsep Average age Years (SD)\tabcellsep Result\\
Inoue, Iwasa, Wakakura and Tomita, 2012\tabcellsep Japan\tabcellsep To study the area efficiency. efficiency of long-term Travoprost monotherapy without (BAC) on IOP and visual\tabcellsep Mean IOP at switch on 16.8±2.6 mmHg.\tabcellsep -5.4±4.7dB\tabcellsep :33/43\tabcellsep 54.8±13.9\tabcellsep Decreased intraocular pressure (IOP)\end{longtable} \par
 
\caption{\label{tab_2}Table 2 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{3} \par 
\begin{longtable}{P{0.23257328990228013\textwidth}P{0.4789902280130293\textwidth}P{0.13843648208469053\textwidth}}
Author s, year\tabcellsep Level of IOP reduction\tabcellsep Progression field of view\\
Inoue, Iwasa, Wakakura and\tabcellsep When treated with Travoprost\tabcellsep 2.8\%-13.9\%\\
Tomita (2012)\tabcellsep 14.1±2.4 mmHg (Before treatment: 16.8±2.6\tabcellsep \\
\tabcellsep mmHg)\tabcellsep \\
Innoue, Tanaka and Tomita\tabcellsep When treated with Tafluprost\tabcellsep 10.3\%-13.8\%\\
(2013)\tabcellsep 12.8±2.8 mmHg Art. (before therapy: 15.7±2.2\tabcellsep \\
\tabcellsep mmHg)\tabcellsep \end{longtable} \par
 
\caption{\label{tab_3}Table 3 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{4} \par 
\begin{longtable}{}
\end{longtable} \par
 
\caption{\label{tab_4}Table 4 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{} \par 
\begin{longtable}{P{0.028419452887537992\textwidth}P{0.04004559270516717\textwidth}P{0.05037993920972644\textwidth}P{0.07104863221884498\textwidth}P{0.48829787234042554\textwidth}P{0.02066869300911854\textwidth}P{0.024544072948328267\textwidth}P{0.01937689969604863\textwidth}P{0.10721884498480243\textwidth}}
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep Year 2022\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep Volume XXII Issue III Version I\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep D D D D )\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep (\\
Author, year\tabcellsep Study type\tabcellsep Population\tabcellsep Intervention/ Control (Comparator)\tabcellsep health outcomes\tabcellsep Results Expenses\tabcellsep Economic Efficiency\tabcellsep Research period\tabcellsep Medical Research\\
Brown 2019\tabcellsep Cost-utility analysis\tabcellsep Patients over 40 years of age\tabcellsep Tafluprost Travoprost\tabcellsep \multicolumn{4}{l}{sensitivity analyzes were also performed with upper and 1.99 QALY (17.9\%) \$1,925 cost/year ICER is missing 3 months a l.92 QALY (17.2\%) \$944 cost/year}\tabcellsep Global Journal of\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \multicolumn{4}{l}{lower IOP limits at 95\% confidence intervals. Tafluprost}\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \multicolumn{4}{l}{remained with the best QALY scores among other}\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \multicolumn{2}{l}{interventions.}\tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \multicolumn{4}{l}{A study by Brown et al. (2019) showed that}\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \multicolumn{4}{l}{even though Travoprost is cheaper than Tafluprost,}\tabcellsep \end{longtable} \par
 
\caption{\label{tab_5}}\end{figure}
 			\footnote{© 2022 Global Journals} 			\footnote{© 2022 Global Journals Systematic Review of Clinical and Economic Evidence for Primary Open-Angle Glaucoma Therapy with Tafluprost vs Travoprost} 		 		\backmatter  			  				\begin{bibitemlist}{1}
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\end{document}
