Systematic review of intraocular pressure-lowering effects of adjunctive medications added to latanoprost.
OBJECTIVE
To evaluate the intraocular pressure (IOP)-lowering effects of adjunctive medications when added to 0.005% latanoprost taken once daily.


METHODS
Pertinent publications were identified through systematic searches of PubMed, Embase, and the Cochrane Controlled Trials Register. Randomized clinical trials with over 85% of patients presenting with primary open-angle glaucoma or ocular hypertension who were treated with the combination treatment of latanoprost were selected. The pooled additional IOP-lowering effects at 1-3 months after a run-in phase of at least 2 weeks on 0.005% latanoprost once daily were calculated using the random effects model.


RESULTS
Nine randomized clinical trials were included. The mean pooled IOP reductions were 3.3 mm Hg (95% CI: 2.1-4.5) at trough and 4.4 mm Hg (95% CI: 3.4-5.4) at peak when adding 0.5% timolol once daily, 2.6 mm Hg (95% CI: 1.9-3.3) at trough and 3.8 mm Hg (95% CI: 2.5-5.2) at peak when adding 0.1/0.15% brimonidine twice daily, 2.6 mm Hg (95% CI: 1.7-3.4) at trough and 3.1 mm Hg (95% CI: 2.6-3.6) at peak when adding 2% dorzolamide twice daily, 2.4 mm Hg (95% CI: 2.0 -2.8) at trough and 2.7 mm Hg (95% CI: 2.2-3.2) at peak when adding 0.5% timolol twice daily, and 2.8 mm Hg (95% CI: 1.5-4.1) at trough and 1.8 mm Hg (95% CI: 1.2-2.3) at peak when adding 1% brinzolamide twice daily.


CONCLUSIONS
The addition of brimonidine, dorzolamide, timolol, or brinzolamide can further lower IOP in eyes being treated with latanoprost. Timolol 0.5% once daily might be the most effective adjunctive medication.
Cheng
Jin-Wei
JW
Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Li
You
Y
Wei
Rui-Li
RL
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D000068438:Brimonidine Tartrate; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D005260:Female; D005901:Glaucoma / Q000188:drug therapy; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000188:drug therapy; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage*; D011810:Quinoxalines / Q000008:administration & dosage*; D013449:Sulfonamides / Q000008:administration & dosage*; D013843:Thiazines / Q000008:administration & dosage*; D013876:Thiophenes / Q000008:administration & dosage*; D013999:Timolol / Q000008:administration & dosage*
D000959:Antihypertensive Agents; D011461:Prostaglandins F, Synthetic; D011810:Quinoxalines; D013449:Sulfonamides; D013843:Thiazines; D013876:Thiophenes; D000068438:Brimonidine Tartrate; D000077338:Latanoprost; D013999:Timolol; C111827:brinzolamide; C062765:dorzolamide