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Abstract #5786 Published in IGR 2-1
Clinical investigation: Comparative acute effects of brimonidine 0.2% versus dorzolamide 2% combined with beta-blockers in glaucoma
Centofanti M; Manni G; Gregori D; Cocco F; Lorenzano D; Bucci MGGraefe's Archive for Clinical and Experimental Ophthalmology 2000; 238: 302-305
PURPOSE: To assess the acute intraocular hypotensive efficacy of brimonidine tartrate 0.2% (a highly selective α2-adrenergic agonist) compared with dorzolamide 2% (a topical carbonic anhydrase inhibitor) as adjunct therapy to topical β-blockers in patients with primary open-angle glaucoma. METHODS: A randomized crossover masked study was performed. The authors enrolled one eye of each of 28 patients who were on different β-blocker therapy. They measured the intraocular pressure (IOP) two hours after the β-blocker instillation; they then randomly administered one of the two drugs and compiled an IOP diurnal curve. One month later, the authors repeated the same procedures with the second drug. The unpaired Mann-Whitney U-test was used to compare decreases in IOP between the two drugs (p < 0.05). RESULTS: Both brimonidine 0.2% and dorzolamide 2% have good ocular hypotensive efficacy, significantly lowering IOP when compared to β-blocker therapy alone, for the whole diurnal curve. Maximum mean percent IOP decrease from baseline was 22.0±15.7% (4.0±2.9 mmHg) for dorzolamide 2% six hours after instillation and 35.5±16.4% (7.0±4.1 mmHg) for brimonidine 0.2% eight hours after administration of the drug. When the authors compared the two treatments, brimonidine 0.2% showed a higher hypotensive effect than 2% dorzolamide after four hours (28.4±16.8% versus 17.6± p=0.04) and eight hours (35.5±16.4% versus 21.6±10.8%; p=0.04). CONCLUSION: This study indicates that 0.2% brimonidine acutely associated with β-blockers is an interesting new combination treatment useful in the management of glaucoma.
Dr. M. Centofanti, Department of Ophthalmology, University of Rome 'Tor Vergata' Rome Italy. email: mcentofanti@lycosmail.com
Classification:
11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
11.5.2 Topical (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)
