24-hour efficacy of the bimatoprost–timolol fixed combination versus latanoprost as first choice therapy in subjects with high-pressure exfoliation syndrome and glaucoma

• Published in: British journal of ophthalmology Vol. 97; no. 7; pp. 857 - 861
• Main Authors: Konstas, Anastasios-Georgios P, Holló, Gábor, Mikropoulos, Dimitrios G, Haidich, Anna-Bettina, Dimopoulos, Antonios T, Empeslidis, Theodoros, Teus, Miguel A, Ritch, Robert
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.07.2013; BMJ Publishing Group LTD
• Subjects: Aged; Aged, 80 and over; Amides - adverse effects; Amides - therapeutic use; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Bimatoprost; Chronic illnesses; Circadian Rhythm - drug effects; Clinical medicine; Cloprostenol - adverse effects; Cloprostenol - analogs & derivatives; Cloprostenol - therapeutic use; Cross-Over Studies; Double-Blind Method; Drug Combinations; Exfoliation Syndrome - drug therapy; Exfoliation Syndrome - physiopathology; Female; Glaucoma; Glaucoma - drug therapy; Glaucoma - physiopathology; Humans; Hypertension; Intraocular pressure; Intraocular Pressure - drug effects; Male; Middle Aged; Ocular Hypertension - drug therapy; Ocular Hypertension - physiopathology; Patients; Prospective Studies; Prostaglandins F, Synthetic - adverse effects; Prostaglandins F, Synthetic - therapeutic use; Timolol - adverse effects; Timolol - therapeutic use; Tonometry, Ocular; Treatment Medical; Treatment Outcome; Visual Field Tests; Visual Fields; Glaucoma; Treatment Medical; Intraocular pressure
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjophthalmol-2012-302843

Aim To compare the 24-h intraocular pressure (IOP) control obtained with the bimatoprost–timolol fixed combination (BTFC) versus latanoprost in newly diagnosed, previously untreated exfoliation syndrome (XFS) or exfoliative glaucoma (XFG) patients with baseline morning IOP greater than 29 mm Hg. Methods One eye of 41 XFS/XFG patients who met inclusion criteria was included in this prospective, observer-masked, crossover, comparison protocol. All subjects underwent a 24-h untreated curve and were then randomised to either evening administered BTFC or latanoprost for 3 months and then switched to the opposite therapy. At the end of each treatment period, patients underwent a treated 24-h IOP assessment. Results 37 patients completed the trial. At baseline, mean untreated 24-h IOP was 31.1 mm Hg. Mean 24-h IOP with BTFC was significantly lower than with latanoprost (18.9 vs 21.2 mm Hg; p<0.001). Furthermore, BTFC reduced IOP significantly more than latanoprost at every time point, for the mean peak and trough 24-h IOP (p<0.001). There was no difference, however, in mean 24-h IOP fluctuation between the two medications (3.8 with BTFC vs 4.2 with latanoprost; p=0.161). Both treatments were well tolerated and there was no statistically significant difference for any adverse event between them. Conclusions As first choice therapy in high-pressure, at-risk exfoliation patients, BTFC controlled mean 24-h IOP significantly better than latanoprost monotherapy.