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Abstract #15807 Published in IGR 2-3
Experience with topical brimonidine (Alphagan 0.2%) in the treatment of glaucomas
Detry-Morel M; Dutrieux CJournal Français d'Ophtalmologie 2000; 23: 763-768
PURPOSE: The main purpose of this study was to assess the systemic safety of brimonidine tartrate 0.2%, an α2 highly selective agonist in patients with glaucoma or ocular hypertension MATERIAL AND METHODS: Brimonidine was administered alone or in combination in 128 patients suffering from glaucoma or ocular hypertension in order to improve intraocular pressure (IOP) and/or to replace a drug, the dose of which was limited due to its secondary effects. In addition to the standard follow-up and IOP reduction evaluation, the study focused on checking the systemic tolerance to brimonidine. RESULTS: The average age of the patients was 65.2 ± 13.8 years and the mean follow-up was 4.5 ± 3.4 months. Brimondine was administered alone in 15 patients (7.8%) and in combination with another drug in the others (92.2%), the combination with a beta-blocking agent being the most frequent combination. One hundred and thirteen of the 128 patients suffered from POAG; 51.6% described systemic side-effects of various degrees (drowsiness, fatigue, general uneasiness, mouth dryness). All these systemic side-effects were significantly more frequent in patients older than 60 years (p < 0.05). They did not seem to be influenced by an concurrent illness or a systemic concurrent treatment with drugs potentially acting with the noradrenergic transmission (monoamine oxydase inhibitors, tricyclic antidepressants, mianserine, α-sympatholytics). Brimonidine was interrupted in 82 patients (64.1%) due to systemic intolerance in 21 patients, allergic blepharo-conjunctivitis in 12 patients, and non-optimal IOP reduction in 42 patients. Considering the all patients and treatments, IOP dropped from 20.5 ± 3.6 mmHg to 19.8 ± 4.6 mmHg at the last examination (p < 0.05). In bitherapies, the IOP reduction observed was not significantly different from the one achieved with the previous association. CONCLUSIONS: These medium-term results have shown that brimonidine was an efficient ocular hypotensive agent that showed satisfactory ocular tolerance in almost all patients. However, its systemic tolerance appeared to be less favorable than previously reported. Systematic eyelid closure and punctal occlusion following each instillation is advisable in older patients.LA: French
Dr. M. Detry-Morel, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium
Classification:
11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
