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Abstract #49017 Published in IGR 14-1
Meta-analysis of α2-adrenergic agonists versus carbonic anhydrase inhibitors as adjunctive therapy
Cheng JW; Cheng SW; Yu DY; Wei RL; Lu GCCurrent Medical Research and Opinion 2012; 28: 543-550
OBJECTIVE: To evaluate the efficacy of α2-adrenergic agonist (AA) brimonidine and topical carbonic anhydrase inhibitors (CAIs) dorzolamide and brinzolamide in reducing intraocular pressure (IOP) when used as adjunctive therapy to β-blockers (BBs) or prostaglandin analogs (PGAs). RESEARCH DESIGN AND METHODS: Pertinent publications were identified through systematic searches of PubMed, EMBASE, and the Cochrane Controlled Trials Register. Randomized controlled trials comparing AA with CAIs in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) who had inadequate IOP control with monotherapy of a BB or PGA. The weighted mean differences (WMD) of IOP-lowering efficacy were calculated by performing meta-analysis. MAIN OUTCOME MEASURES: The main efficacy measures were the reduction from baseline to end of treatment in IOP at peak, trough, and diurnal curve. RESULTS: Eleven published randomized clinical trials involving 1493 patients were included in the meta-analysis. As adjunctive therapy, the IOP reduction was greater in the brimonidine group than in the CAI group at peak (WMD: 0.99 mmHg [95% confidence interval, 0.45 to 1.53]) and diurnal curve (WMD: 0.62 mmHg [0.07 to 1.18]). As adjunctive therapy to BBs, brimonidine was more effective than CAIs in reducing IOP at peak (WMD: 0.85 mmHg [0.42 to 1.29]) and trough (WMD: 0.47 mmHg [0.12 to 0.83]). As adjunctive therapy to PGAs, brimonidine resulted greater reduction in peak IOP than CAIs (WMD: 1.04 mmHg [0.08 to 2.00]). CONCLUSIONS: Brimonidine provides greater IOP-lowering efficacy than topical carbonic anhydrase inhibitors as adjunctive therapy to BBs or PGAs.
Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University , Shanghai , China.
Full articleClassification:
11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
11.5.1 Systemic (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)
11.4 Prostaglandins (Part of: 11 Medical treatment)
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
