title: Comparing diurnal and nocturnal effects of brinzolamide and timolol on intraocular pressure in patients receiving latanoprost monotherapy.
abstract: OBJECTIVE
  To compare the diurnal and nocturnal effects of brinzolamide and timolol on intraocular pressure (IOP) in patients already receiving monotherapy with latanoprost.
  
  
  METHODS
  Prospective, open-label, and crossover clinical trial.
  
  
  METHODS
  Twenty-six patients with glaucoma or ocular hypertension (ages, 44-79 years) who were receiving treatment with 0.005% latanoprost once every evening.
  
  
  METHODS
  Baseline data of 24-hour IOP were collected in a sleep laboratory while patients were receiving latanoprost monotherapy. Measurements were taken every 2 hours in the sitting and supine positions during the 16-hour diurnal/wake period and in a supine position during the 8-hour nocturnal/sleep period. Patients were randomly assigned to receive an add-on treatment with either 1% brinzolamide 3 times per day or 0.5% timolol gel forming solution once every morning for 8 weeks, and then crossed over to receive the other add-on treatment. At the end of each add-on treatment period, 24-hour IOP data were collected.
  
  
  METHODS
  Diurnal and nocturnal IOP means were compared among the baseline, the brinzolamide add-on treatment, and the timolol add-on treatment.
  
  
  RESULTS
  During the diurnal period, the mean IOP under brinzolamide or timolol add-on treatment was significantly lower than the baseline IOP in both the sitting and supine positions. There was no statistical difference between the 2 add-on treatments. During the nocturnal period, the supine IOP under brinzolamide add-on treatment was significantly lower than both the baseline and the timolol add-on treatment. There was no difference in nocturnal IOP between the timolol add-on treatment and the baseline.
  
  
  CONCLUSIONS
  In patients already receiving the latanoprost monotherapy, adding brinzolamide or timolol significantly reduced IOP during the diurnal period. However, only the brinzolamide add-on treatment had an IOP-lowering efficacy during the nocturnal period.
authors.affiliation: The Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, California 92093-0946, USA. joliu@ucsd.edu
authors.forename: John H K
authors.initials: JH
authors.lastname: Liu
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Medeiros
authors.forename: J Rigby
authors.initials: JR
authors.lastname: Slight
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D002940:Circadian Rhythm / Q000187:drug effects*; D018592:Cross-Over Studies; D004359:Drug Therapy, Combination; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006339:Heart Rate; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy; D011187:Posture; D011446:Prospective Studies; D011461:Prostaglandins F, Synthetic / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D013843:Thiazines / Q000627:therapeutic use*; D013999:Timolol / Q000627:therapeutic use*; D014065:Tonometry, Ocular
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002257:Carbonic Anhydrase Inhibitors; D011461:Prostaglandins F, Synthetic; D013449:Sulfonamides; D013843:Thiazines; D000077338:Latanoprost; D013999:Timolol; C111827:brinzolamide