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Abstract #13978 Published in IGR 8-3

Twice-daily 0.2% brimonidine-0.5% timolol fixed-combination therapy vs monotherapy with timolol or brimonidine in patients with glaucoma or ocular hypertension: A 12-month randomized trial

Sherwood MB; Craven ER; Chou C; Dubiner HB; Batoosingh AL; Schiffman RM; Whitcup SM
Archives of Ophthalmology 2006; 124: 1230-1238


OBJECTIVE: To evaluate the intraocular pressure (IOP)-lowering efficacy and safety of a fixed combination of 0.2% brimonidine tartrate and 0.5% timolol maleate (fixed brimonidine-timolol) compared with the component medications. METHODS: In 2 identical, 12-month, randomized, double-masked multicenter trials, patients with ocular hypertension or glaucoma were treated with fixed brimonidine-timolol twice daily (n = 385), 0.2% brimonidine tartrate 3 times daily (n = 382), or 0.5% timolol maleate twice daily (n = 392). MAIN OUTCOME MEASURES: Mean change from baseline IOP and incidence of adverse events. RESULTS: The mean decrease from baseline IOP during 12-month follow-up was 4.4 to 7.6 mmHg with fixed brimonidine-timolol, 2.7 to 5.5 mmHg with brimonidine, and 3.9 to 6.2 mmHg with timolol. Mean IOP reductions were significantly greater with fixed brimonidine-timolol compared with timolol at all measurements (P ≤ .002) and brimonidine at 8 am, 10 am, and 3 pm (P < .001) but not at 5 pm. The incidence of treatment-related adverse events in the fixed-combination group was lower than that in the brimonidine group (P = .006) but higher than that in the timolol group (P < .001). The rate of discontinuation for adverse events was 14.3% with the fixed combination, 30.6% with brimonidine, and 5.1% with timolol. CONCLUSIONS: Twice-daily fixed brimonidine-timolol therapy provides sustained IOP lowering superior to monotherapy with either thrice-daily brimonidine or twice-daily timolol and is better tolerated than brimonidine but less well tolerated than timolol.Application to Clinical Practice Fixed brimonidine-timolol is an effective and convenient IOP-lowering therapy.

Dr. M.B. Sherwood, Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL, USA


Classification:

11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)



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