A 6-month randomized clinical trial of bimatoprost 0.03% versus the association of timolol 0.5% and latanoprost 0.005% in glaucomatous patients.
BACKGROUND
New effective hypotensive agents have been recently introduced into clinical practice, but often more than one drug has to be used to prevent further visual field loss. The aim of this study was to evaluate the intraocular pressure (IOP)-lowering efficacy and safety of bimatoprost 0.03% compared with the association of timolol 0.5% and latanoprost 0.005% in open-angle glaucoma patients.


METHODS
In this 6-month, prospective, parallel, randomised, investigator-masked clinical trial, 61 glaucomatous patients treated with timolol 0.5% twice in both eyes were enrolled. The timolol 0.5% was replaced by bimatoprost 0.03% once daily (group I) or by latanoprost 0.005% plus timolol 0.5% (group II). IOP measurements were performed at the baseline visit and at days 15, 30, 60, 90, 120 and 180. Digital colour photography was used to evaluate topical side effects.


RESULTS
Fifty-six of the 61 patients were included for the intent-to-treat analysis (28 in group I and 28 in group II). Baseline mean IOP was similar in the two groups (p=0.5). Both treatments lowered the mean IOP at every visit significantly compared with the baseline (p<0.01). Comparing the IOP reductions obtained by the two treatments, no significant differences were found at any time during the study. Conjunctival hyperaemia, skin pigmentation and eyelash growth in group I and headache in group II were the most common side effects observed during the study.


CONCLUSIONS
Bimatoprost and the association of latanoprost plus timolol were equally effective in lowering the IOP in glaucomatous patients previously treated with timolol. Latanoprost plus timolol showed a better ocular safety profile.
Manni
Gianluca
G
Ophthalmology Department, University of Rome Tor Vergata, Italy.
Centofanti
Marco
M
Parravano
Mariacristina
M
Oddone
Francesco
F
Bucci
Massimo G
MG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069580:Bimatoprost; D003008:Cloprostenol / Q000031:analogs & derivatives; D004359:Drug Therapy, Combination; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008055:Lipids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012449:Safety; D016037:Single-Blind Method; D013999:Timolol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D000577:Amides; D000959:Antihypertensive Agents; D008055:Lipids; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic; D003008:Cloprostenol; D000077338:Latanoprost; D013999:Timolol; D000069580:Bimatoprost