Prostaglandin analog treatment of glaucoma and ocular hypertension.
OBJECTIVE
To review available data related to the use of prostaglandin analogs (bimatoprost, latanoprost, travoprost, unoprostone) in the management of ocular hypertension and open-angle glaucoma.


METHODS
Primary and review articles were identified from a MEDLINE search (1966-May 2001) and requested information from product manufacturers.


METHODS
All available information, including that published in articles and abstracts, which was deemed relevant was included in this review. Limited data have been published to date.


RESULTS
The prostaglandin analogs appear to be effective, well-tolerated agents for the reduction of intraocular pressure (IOP) in patients with primary open-angle glaucoma and ocular hypertension. This drug class offers an alternative for patients who do not achieve control with another topical antiglaucoma agent or for those with a contraindication to first-line therapy with beta-adrenergic antagonists. Based on preliminary clinical data, bimatoprost, latanoprost, and travoprost appear to be at least as effective as timolol, while the effectiveness of unoprostone is similar or slightly less. Prostaglandin analogs may be used in conjunction with other antiglaucoma medications, although further studies must establish the optimal combination. Whether clinical experience will yield outcomes in favor of one of the prostaglandin analogs remains to be determined. Patients should be educated on adverse events associated with prostaglandin analogs, particularly the potential for changes in the pigmentation of the iris and eyelashes.


CONCLUSIONS
Bimatoprost, latanoprost, and travoprost appear to be equivalent to the current standard of therapy in the topical treatment of elevated IOP. Further clinical data published in article versus abstract format is required to better assess potential differences among these 3 agents.
Alexander
Christy L
CL
School of Pharmacy and Pharmacal Sciences, Purdue University, West Lafayette, IN, USA.
Miller
Sarah J
SJ
Abel
Steven R
SR
D000577:Amides; D000959:Antihypertensive Agents / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use; D000069580:Bimatoprost; D003008:Cloprostenol / Q000031:analogs & derivatives / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use; D015237:Dinoprost / Q000031:analogs & derivatives* / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use; D004356:Drug Storage; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006801:Humans; D000077338:Latanoprost; D008055:Lipids / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use; D009798:Ocular Hypertension / Q000188:drug therapy*; D011453:Prostaglandins / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use; D011461:Prostaglandins F, Synthetic / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000069557:Travoprost
D000577:Amides; D000959:Antihypertensive Agents; D008055:Lipids; D011453:Prostaglandins; D011461:Prostaglandins F, Synthetic; D003008:Cloprostenol; C072630:isopropyl unoprostone; D000077338:Latanoprost; D015237:Dinoprost; D000069580:Bimatoprost; D000069557:Travoprost