Abstract (IGR: 3-2) | International Glaucoma Review #

Abstract #6460 Published in IGR 3-2

Comparison of the clinical success and quality-of-life impact of brimonidine 0.2% and betaxolol 0.25% suspension in patients with elevated intraocular pressure

Cantor LB; Hoop J; Katz LJ; Flartey K
Clinical Therapeutics 2001; 23: 1032-1039

BACKGROUND: Brimonidine tartrate 0.2%, a selective alpha₂-adrenergic receptor agonist, and betaxolol 0.25% suspension, a cardioselective beta₁-adrenergic receptor antagonist, are used in the treatment of elevated intraocular pressure (IOP). OBJECTIVE: This study compared the clinical success and quality-of-life impact of four weeks of treatment with brimonidine 0.2% BID compared with those of four weeks of treatment with betaxolol 0.25% suspension BID in patients with elevated IOP. METHODS: This was a multisite, double-masked, comparative clinical trial in patients with glaucoma or ocular hypertension. Patients were randomly assigned to receive either brimonidine or betaxolol BID. Morning IOP was measured at baseline and at weeks 1 and 4 using Goldmann applanation. Efficacy was determined by reduction in IOP from baseline. Patients experiencing a 20% reduction in IOP were considered to have a successful IOP-lowering response. The Glaucoma Disability Index questionnaire was administered at week 4 to assess quality-of-life factors and the incidence of adverse events. Ophthalmic examinations were conducted at each visit. RESULTS: One hundred and fifty-nine patients were randomized to treatment and completed the study, 81 receiving brimonidine and 78 receiving betaxolol. The majority were white (77.4%) and female (61.6%), and had a diagnosis of open-angle glaucoma (56.0%). After four weeks of treatment, both brimonidine and betaxolol effectively lowered IOP from baseline (mean IOP reductions: brimonidine, 5.96 mmHg; betaxolol, 5.07 mmHg; p = NS). However, a significantly higher percentage of brimonidine patients (52/81 (64.2%)) than betaxolol patients (37/78 (47.4%)) had a 20% reduction in IOP (p = 0.033). No serious adverse events were reported with either study medication. On the quality-of-life assessments, more betaxolol patients reported hyperemia (p = 0.011), and the reported hyperemia was significantly more severe in betaxolol patients (p = 0.009). CONCLUSIONS: After four weeks of treatment, brimonidine 0.2% BID was clinically successful in significantly more patients and was better tolerated than four weeks of treatment with betaxolol 0.25% BID in this population.

Dr L.B. Cantor, Glaucoma Services, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN 46202; USA. lcantor@iupui.edu

Classification:

11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)

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