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Abstract #22056 Published in IGR 10-4
A comparison of dorzolamide/timolol-fixed combination versus bimatoprost in patients with open-angle glaucoma who are poorly controlled on latanoprost
Sharpe ED; Williams RD; Stewart JA; Nelson LA; Stewart WCJournal of Ocular Pharmacology and Therapeutics 2008; 24: 408-413
PURPOSE: The aim of this study was to evaluate the intraocular pressure (IOP) efficacy and safety of dorzolamide/timolol in fixed combination (DTFC) versus bimatoprost in open-angle glaucoma (OAG) patients poorly controlled (≥21 mmHg) on latanoprost. METHODS: This was a prospective, double-masked, randomized, controlled, cross-over evaluation. After a 6-week wash-out period, the patients then returned for baseline diurnal curve testing every 2 h (8 AM to 8 PM). Patients with an IOP of 22-29 mmHg inclusive at 8 AMwere randomized to either bimatoprost dosed each evening or DTFC twice-daily. Patients returned in 8 weeks for the Period 1 diurnal curve and were switched to the opposite treatment. Patients again returned in 8 weeks for the Period 2 diurnal curve. RESULTS: Of the 29 patients, mean untreated baseline IOP (visit 2) was 24.6 ± 2.6 mmHg and treatment mean IOP was statistically lower with bimatoprost 17.6 ± 2.0 mmHg than for DTFC 18.8 ± 2.5 mmHg (P = 0.03), as was the IOP range (P = 0.02) and IOP peak (P = 0.003). No significant differences were found between DTFC and bimatoprost at individual time points after a modified Bonferroni correction (> 0.02). DTFC demonstrated a greater incidence of stinging or burning (n = 12) than bimatoprost (n = 0; P = < 0.0001). CONCLUSIONS: This study suggests that OAG patients generally can obtain similar IOP control at individual time points (when a Bonferroni correction is considered) by switching to either DTFC or bimatoprost, but overall diurnal control is statistically better with bimatoprost.
Dr. W.C. Stewart, 5001 LBJ Freeway, Dallas, TX 75244, USA. info@prnorb.com