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Abstract #6165 Published in IGR 2-2
The additive intraocular pressure-lowering effect of latanoprost 0.005% daily once and pilocarpine 2% t.i.d. in patients with open-angle glaucoma or ocular hypertension: a six-month, randomized, multicenter study
Diestelhorst M; Hutz; Schmickler; Diestelhorst; Wiedemann; Henjes; Borchart; Lang; Schmitz-Valckenberg P; MesterGraefe's Archive for Clinical and Experimental Ophthalmology 2000; 238: 433-439
PURPOSE: To compare the additional intraocular pressure-lowering effect of latanoprost 0.005% administered once daily with that of pilocarpine 2% administered three times daily in patients with primary open-angle glaucoma or ocular hypertension currently on monotherapy with timolol 0.5% twice daily. METHODS: In a six-month, multicenter, randomized, open-label study, 242 patients with POAG or OH whose IOP was not controlled with timolol 0.5% b.i.d. were enrolled. Eyes had not been treated with pilocarpine or latanoprost for at least two years. An analysis of covariance with diurnal IOP change from baseline to month 6 for study eyes was performed. RESULTS: Four patients on latanoprost 0.005% and 35 on pilocarpine 2% did not complete the study (p < 0.001). Two hundred and forty patients were included in the intent-to-treat analysis. For both treatments, the diurnal IOP reduction after six months was statistically significant (p < 0.001). IOP (mean ± SD) was reduced from 23.3 ± 2.8 to 17.8 ± 2.8 (-5.6) mmHg in the latanoprost 0.005% group and from 23.0 ± 3.2 to 18.5 ± 2.4 (-4.8) mmHg in pilocarpine 2% t.i.d. treated eyes. The mean difference of -0.8 mmHg (per protocol, PP) and -1.6 mmHg (intent-to-treat, ITT) was statistically significant (p < 0.04, PP; p < 0.001, ITT) in favor of latanoprost 0.005%. Two eyes treated with latanoprost showed an iris color change. Thirty-six patients in the latanoprost group and 106 in the pilocarpine 2% group reported ocular adverse events (p < 0.001). CONCLUSIONS: From the data, it is concluded that the additivity of latanoprost 0.005% is at least as effective as pilocarpine 2% t.i.d. in reducing IOP when added to eyes currently on monotherapy with timolol 0.5% b.i.d. Latanoprost was better tolerated than pilocarpine 2% eye drops in this study. The increase in iris pigmentation requires further investigation.
Dr. M. Diestelhorst, Department of Ophthalmology, University of Cologne, 50931 Cologne, Germany
Classification:
11.2 Cholinergic drugs (Part of: 11 Medical treatment)
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
11.4 Prostaglandins (Part of: 11 Medical treatment)
