24-hour intraocular pressure control obtained with evening- versus morning-dosed travoprost in primary open-angle glaucoma.
OBJECTIVE
To evaluate the quality of 24-hour intraocular pressure (IOP) control between morning- and evening-dosed travoprost in primary open-angle glaucoma patients.


METHODS
Prospective, crossover, double-masked comparison.


METHODS
After a 6-week medicine-free period, 33 patients were randomized to receive travoprost dosed in the morning or evening. After 8 weeks of treatment, a 24-hour IOP curve was performed at 6 am, 10 am, 2 pm, 6 pm, 10 pm, and 2 am. Patients were then treated with the opposite dosing regimen for another 8 weeks, after which the 24-hour IOP curve was repeated.


METHODS
Twenty-four-hour IOP.


RESULTS
The untreated mean 24-hour IOP was 23.6+/-2.0 mmHg. There were no differences for mean 24-hour IOP between the morning (17.5+/-1.9 mmHg) and evening (17.3+/-1.9 mmHg) dosings (P = 0.7). At 10 am, the evening dosing provided a statistically lower IOP (17.2+/-2.1 mmHg) than the morning dosing (19.1+/-2.5 mmHg) (P = 0.02). Evening dosing demonstrated a statistically lower 24-hour fluctuation of IOP (3.2+/-1.0 mmHg) than morning dosing (4.0+/-1.5 mmHg) (P = 0.01). Safety was similar, with conjunctival hyperemia being the most common adverse event (n = 9 [27% for morning dosing] and n = 11 [33% for evening dosing], P = 0.6).


CONCLUSIONS
This study suggests that both morning and evening dosings of travoprost provide effective 24-hour IOP reduction. However, the evening dosing of travoprost demonstrates slightly greater daytime efficacy, with a narrower range of 24-hour pressure.
Konstas
Anastasios G P
AG
Glaucoma Unit, Department of Ophthalmology, A University, AHEPA Hospital, Thessaloniki, Greece.
Mikropoulos
Dimitrios
D
Kaltsos
Kostantinos
K
Jenkins
Jessica N
JN
Stewart
William C
WC
D002940:Circadian Rhythm; D003008:Cloprostenol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003228:Conjunctiva / Q000098:blood supply; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005123:Eye / Q000187:drug effects; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced; D007429:Intraocular Pressure / Q000187:drug effects*; D011537:Pruritus / Q000139:chemically induced; D000069557:Travoprost; D016896:Treatment Outcome
D003008:Cloprostenol; D000069557:Travoprost