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Abstract #8965 Published in IGR 5-2
Replacing maximum-tolerated medications with latanoprost versus adding latanoprost to maximum-tolerated medications: a two-center randomized prospective trial
Gandolfi SA; Rossetti L; Cimino L; Mora P; Tardini M; Orzalesi NJournal of Glaucoma 2003; 12: 347-353
PURPOSE: To compare the replacement of all drugs with latanoprost 0.005% once a day in glaucomatous eyes with poorly controlled intraocular pressure (IOP) on combination therapy, versus the addition of latanoprost to the pre-existing treatment. PATIENTS AND METHODS: Study DESIGN: prospective, investigator-masked, two-center, randomized clinical trial lasting three months. Eligibility criteria: open-angle glaucoma; IOP ≥ 21 mmHg upon the combination of a non-selective beta-blocker with pilocarpine or dorzolamide or both; no previous bulbar surgery; and prior glaucoma therapy lasting at least two years. Two treatment arms: the addition of latanoprost 0.005% QD to the pre-existing therapy (group A); and substitution of latanoprost alone (group B). RESULTS: One hundred and thirty-six eyes (68 eyes/treatment group) were randomized according to IOP level and the number of adjunctive medications to beta blocker. Both treatments provided a significant IOP decrease over baseline (from 23.5 ± 1.4 to 19.7 ± 1.9 mmHg in group A (p < 0.001); from 23.2 ± 1.3 to 20.1 ± 2.2 mmHg in group B (p < 0.001), paired Student's t test). At the end of the follow-up period, group A showed a higher number of intraocular readings less than or equal to 18 mmHg than group B (42.6 versus 30.8%; Fisher exact test: p = 0.018). CONCLUSIONS: In eyes showing an IOP greater than 21 mmHg upon combination therapy, substitution of the pre-existing treatment with latanoprost can provide a significant IOP decrease. However, adding latanoprost to the pre-existing therapy is more likely to achieve a target IOP of less than or equal to 18 mmHg.
Dr. S.A. Gandolfi, Associate Professor of Ophthalmology, Instituto di Oftalmologia, Via Gramsci 14, 43100 Parma, Italy. s.gandolfi@rsadvnet.it
Classification:
11.4 Prostaglandins (Part of: 11 Medical treatment)