24-Hour Intraocular Pressure Control Obtained with Evening- versus Morning-Dosed Travoprost in Primary Open-Angle Glaucoma

• Published in: Ophthalmology (Rochester, Minn.) Vol. 113; no. 3; pp. 446 - 450
• Main Authors: Konstas, Anastasios G.P., Mikropoulos, Dimitrios, Kaltsos, Kostantinos, Jenkins, Jessica N., Stewart, William C.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2006; Elsevier
• Subjects: Biological and medical sciences; Circadian Rhythm; Cloprostenol - administration & dosage; Cloprostenol - adverse effects; Cloprostenol - analogs & derivatives; Cloprostenol - therapeutic use; Conjunctiva - blood supply; Cross-Over Studies; Double-Blind Method; Drug Administration Schedule; Eye - drug effects; Glaucoma and intraocular pressure; Glaucoma, Open-Angle - drug therapy; Glaucoma, Open-Angle - physiopathology; Humans; Hyperemia - chemically induced; Intraocular Pressure - drug effects; Medical sciences; Miscellaneous; Ophthalmology; Pruritus - chemically induced; Travoprost; Treatment Outcome; Eye disease; Ophthalmology; Open angle glaucoma; Comparative study; Primary; Intraocular pressure
• ISSN: 0161-6420; 1549-4713
• DOI: 10.1016/j.ophtha.2005.10.053

To evaluate the quality of 24-hour intraocular pressure (IOP) control between morning- and evening-dosed travoprost in primary open-angle glaucoma patients. Prospective, crossover, double-masked comparison. After a 6-week medicine-free period, 33 patients were randomized to receive travoprost dosed in the morning or evening. After 8 weeks of treatment, a 24-hour IOP curve was performed at 6 am, 10 am, 2 pm, 6 pm, 10 pm, and 2 am. Patients were then treated with the opposite dosing regimen for another 8 weeks, after which the 24-hour IOP curve was repeated. Twenty-four–hour IOP. The untreated mean 24-hour IOP was 23.6±2.0 mmHg. There were no differences for mean 24-hour IOP between the morning (17.5±1.9 mmHg) and evening (17.3±1.9 mmHg) dosings ( P = 0.7). At 10 am, the evening dosing provided a statistically lower IOP (17.2±2.1 mmHg) than the morning dosing (19.1±2.5 mmHg) ( P = 0.02). Evening dosing demonstrated a statistically lower 24-hour fluctuation of IOP (3.2±1.0 mmHg) than morning dosing (4.0±1.5 mmHg) ( P = 0.01). Safety was similar, with conjunctival hyperemia being the most common adverse event (n = 9 [27% for morning dosing] and n = 11 [33% for evening dosing], P = 0.6). This study suggests that both morning and evening dosings of travoprost provide effective 24-hour IOP reduction. However, the evening dosing of travoprost demonstrates slightly greater daytime efficacy, with a narrower range of 24-hour pressure.