title: A meta-analysis of topical prostaglandin analogues intra-ocular pressure lowering in glaucoma therapy.
abstract: OBJECTIVE
  To compare the efficacy of latanoprost, bimatoprost and travoprost for lowering IOP in patients with glaucoma.
  
  
  METHODS
  In order to carry out this meta-analysis, randomized trials (2001-2004) were identified on Medline and EMBASE using the following key words: glaucoma, ocular hypertension (OHT), randomization, trial, latanoprost, bimatoprost and travoprost. The studies had to compare at least two prostaglandin analogues as mono-therapy. Cross-over experimental designs were excluded. The main outcome measure was IOP at final visit. Statistical analyses included random effects, pooled estimates of treatment effects, tests for publication bias, and random-effects models to obtain adjusted treatment effects on final IOP after lowering for baseline IOP, and duration of follow-up. Random effects Poisson regression models were used to estimate the adjusted effects of treatments on response rates (IOP < 18 mmHg).
  
  
  RESULTS
  Nine studies were used in the analysis. Patient mean age varied from 56.7 to 68.8 years and baseline IOP ranged from 22.3 to 26.5 mmHg. Three hundred and seventy-eight patients were treated with bimatoprost, 385 with travoprost and 555 with latanoprost. Patients treated with travoprost and bimatoprost had lower IOP levels at the end of follow-up (-0.98 mmHg [95% CI: -2.08; 0.13; p = 0.08] and -1.04 mmHg [95% CI: -2.11;0.04; p = 0.06], respectively) than those treated with latanoprost. The combined effect of newer prostaglandin analogues (bimatoprost/travoprost) was an adjusted decrease of 1.00 mmHg [95% CI: -1.91;-0.10], p = 0.03], or a 17% higher adjusted response rate (Incidence Rate Ratio 1.17, 95% CI, 1.00-1.35, p = 0.04), compared to latanoprost.
  
  
  CONCLUSIONS
  Travoprost and bimatoprost may have greater efficacy in lowering IOP for patients with OHT or glaucoma.
authors.affiliation: Hôpital Edouard Herriot, Service d'ophtalmologie, 5, Place Arsonval, F-69003 Lyon, France.
authors.forename: Ph
authors.initials: P
authors.lastname: Denis
authors.forename: A
authors.initials: A
authors.lastname: Lafuma
authors.forename: B
authors.initials: B
authors.lastname: Khoshnood
authors.forename: V
authors.initials: V
authors.lastname: Mimaud
authors.forename: G
authors.initials: G
authors.lastname: Berdeaux
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000577:Amides / Q000008:administration & dosage; D000069580:Bimatoprost; D003008:Cloprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008055:Lipids / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D011336:Probability; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage; D011465:Prostaglandins, Synthetic / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D014065:Tonometry, Ocular; D000069557:Travoprost; D016896:Treatment Outcome
chemical_list: D000577:Amides; D008055:Lipids; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic; D011465:Prostaglandins, Synthetic; D003008:Cloprostenol; D000077338:Latanoprost; D000069580:Bimatoprost; D000069557:Travoprost