[Development of conjunctival hyperemia with the use of a fixed combination of latanoprost/timolol: systematic review and meta-analysis of clinical trials].
OBJECTIVE
To asses the association of conjunctival hyperemia with the use of a fixed combination of latanoprost/timolol, through a systematic review and meta-analysis of clinical trials in patients with glaucoma.


METHODS
A systematic review of published clinical trials of latanoprost/timolol and other competitors was conducted in Medline, Embasse and Cochrane Controlled Clinical Trials Register, between 2000 and 2007. Statistical analysis included calculation of the odds ratio (OR) with its 95% confidence interval (CI) using the fixed effects model of Mantel-Haenszel and the random effects model of Der Simonian and Laird. To assess the heterogeneity between trials the Cochrane Q test and the I(2) rate were calculated. The conjunctival hyperemia rates obtained were compared with the Chi-square test.


RESULTS
A total of 8 clinical trials comparing latanoprost/timolol fixed combination with different therapeutic options were found. As trial heterogeneity was moderate (Q: 14.64; df=7; p=0.041; I(2)= 52.2%) a random effects model was used. The final OR was 0.47 (CI 95%: 0.24-0.90); p = 0.024. The total conjunctival hyperemia incidence was 2.9% in the latanoprost/timolol group and 7.0% for the competitors (p<0.0001).


CONCLUSIONS
The use of a fixed combination of latanoprost/timolol is associated with a significant reduction (53%; CI 95%: 10%-76%) in the development of conjunctival hyperemia against the other compared options for the treatment of glaucoma.
Vinuesa-Silva
J M
JM
Facultad de Medicina, Universidad de Salamanca, Salamanca, España.
Vinuesa-Silva
I
I
Pinazo-Durán
M D
MD
Soto-Alvarez
J
J
Delgado-Ortega
L
L
Díaz-Cerezo
S
S
D000368:Aged; D000068438:Brimonidine Tartrate; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003008:Cloprostenol / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D003229:Conjunctival Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D018592:Cross-Over Studies; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005901:Glaucoma / Q000188:drug therapy; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D000077338:Latanoprost; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy; D016017:Odds Ratio; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D011810:Quinoxalines / Q000008:administration & dosage / Q000627:therapeutic use; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use; D013843:Thiazines / Q000008:administration & dosage / Q000627:therapeutic use; D013999:Timolol / Q000008:administration & dosage* / Q000627:therapeutic use; D000069557:Travoprost
D004338:Drug Combinations; D011461:Prostaglandins F, Synthetic; D011810:Quinoxalines; D013449:Sulfonamides; D013843:Thiazines; D003008:Cloprostenol; D000068438:Brimonidine Tartrate; D000077338:Latanoprost; D013999:Timolol; C111827:brinzolamide; D000069557:Travoprost