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Abstract #6175 Published in IGR 2-2
Comparison of the efficacy and safety of latanoprost 0.005% compared to brimonidine 0.2% or dorzolamide 2% when added to a topical beta-adrenergic blocker in patients with primary open-angle glaucoma or ocular hypertension
Stewart WC; Sharpe ED; Day DG; Kolker AE; Konstas AG; Lee WH; Rieser JC; Chopra H; Holmes KTJournal of Ocular Pharmacology and Therapeutics 2000; 16: 251-259
The purpose of this study was to evaluate the ocular hypotensive efficacy and safety of latanoprost 0.005% (Xalatan®, Pharmacia and Upjohn), brimonidine (Alphagan®, Allergan), and dorzolamide (Trusopt®, Merck Inc.) when added to a beta-blocker in patients with ocular hypertension or primary open-angle glaucoma. This was a multicenter, retrospective analysis which included all reviewed patient records in which latanoprost, brimonidine or dorzolamide were added to a beta-blocker for at least three months. Patients who were treated for less than three months, who failed therapy due to ineffectiveness of the medicine or an adverse event also were included. The study included 141 patients. Latanoprost (n = 50) showed an intraocular pressure of 16.7 ± 3.3 mmHg (-6.3 ± 4.1 mmHg, p < 0.001), brimonidine (n = 24) 17.4 ± 4.9 mmHg (-4.2 ± 4.5 mmHg, p < 0.001), and dorzolamide (n = 67) 20.1 ± 6.1 mmHg (-3.1 ± 5.1 mmHg, p < 0.001) at three months. A significant difference was observed in the absolute level of intraocular pressure (p < 0.005) and the change from baseline between groups (p < 0.005) at three months. A significant difference was observed between groups in the success rate of therapy between latanoprost (70%), brimonidine (58%) and dorzolamide (40%) (p = 0.008). No significant differences were observed between groups for rate or type of adverse events leading to discontinued therapy. This study showed that latanoprost, when added to beta-blockers, compares favorably in ocular hypotensive efficacy and is similar in safety to brimonidine and dorzolamide. Latanoprost 0.005% (Xalatan®, Pharmacia and Upjohn) was recently released onto the commercial market. In clinical trials leading to regulatory approval, latanoprost has mostly been evaluated as either monotherapy or an adjunctive agent added to one other medicine. Previously sponsored clinical trials evaluating adjunctive therapy have had several limitations, however. First, several of these trials have been performed in only a relatively small number of patients. Second, most of these trials were designed before several of the newer products had come into the marketplace (e.g., apraclonidine, brimonidine and dorzolamide). Consequently, few clinical comparisons with latanoprost have been made to these newer products. In this current study, the retrospective evaluation was carried out of the efficacy and safety of latanoprost 0.005% once daily, brimonidine 0.2% twice daily or dorzolamide 2% twice daily added to a topical beta-blocker over three months of chronic therapy.
Classification:
11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
11.4 Prostaglandins (Part of: 11 Medical treatment)
11.5.2 Topical (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)
