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Abstract #45874 Published in IGR 13-2
Timolol versus brinzolamide added to travoprost in glaucoma or ocular hypertension
Pfeiffer NGraefe's Archive for Clinical and Experimental Ophthalmology 2011; 249: 1065-1071
Background: To compare the efficacy and safety of timolol 0.5% versus brinzolamide 1.0% when added to travoprost monotherapy in patients with primary open-angle glaucoma or ocular hypertension. Methods: Patients meeting selection criteria (IOP one eye 19 mmHg and (less-than or equal to)32 mmHg and IOP both eyes (less-than or equal to)32 mmHg at 8:00 h) were switched to travoprost monotherapy for 4 weeks. Patients then insufficiently controlled on travoprost (IOP at 8:00 h (greater-than or equal to)19 mmHg) at baseline were randomized to receive either travoprost and brinzolamide or travoprost and timolol in a double-masked fashion for 12 weeks. Results: Two hundred and fifty-three patients underwent the 4-week run-in period. Switching to travoprost resulted in adequate IOP control (<19 mmHg) for 21.7% of patients. After 3 months of treatment, both drug combinations statistically significantly reduced the mean IOP at each time point (8:00, 12:00 and 16:00 h) and the mean diurnal IOP, which was 17.9 (plus or minus) 2.6 mmHg for the brinzolamide group and 17.0 (plus or minus) 3.2 mmHg for the timolol group. Both combinations were well-tolerated. However, a statistically significant difference occurred at 16:00 h, with pressures of 16.4 (plus or minus) 3.2 mmHg and 17.3 (plus or minus) 2.8 mmHg for the timolol and brinzolamide groups, respectively (p = 0.038). Fifty percent of patients reported one adverse event, whereas in 13.2% three or more adverse effects were named. Hyperemia was found most often (6.3% of the patients). Conclusion: Both adjunctive combinations moderately reduced IOP in patients inadequately controlled with travoprost monotherapy, with timolol being slightly stronger 8 hours after instillation. Adjunctive treatment with brinzolamide and travoprost may be an alternative for patients not tolerant or not responsive to treatment with timolol and travoprost.
N. Pfeiffer. Department of Ophthalmology, Mainz University, Langenbeckstr. 1, Mainz, 55131, Germany. Email: pfeiffer@augen.klinik.uni-mainz.de
Classification:
11.5.1 Systemic (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
11.4 Prostaglandins (Part of: 11 Medical treatment)
