Control of intraocular pressure and fluctuation with fixed-combination brimonidine-timolol versus brimonidine or timolol monotherapy.
OBJECTIVE
To evaluate control of intraocular pressure (IOP) and IOP fluctuation in patients with ocular hypertension or glaucoma treated with fixed-combination brimonidine-timolol compared with brimonidine or timolol monotherapy.


METHODS
Post hoc analysis of data from 2 identical, 12-month, randomized, double-masked, multicenter trials.


METHODS
Patients were treated bilaterally with fixed brimonidine-timolol twice a day (n = 385), brimonidine tartrate 0.2% 3 times a day (n = 382), or timolol 0.5% twice a day (n = 392). Diurnal IOP was measured at follow-up visits at weeks 2 and 6 and months 3, 6, 9, and 12. IOP fluctuation was defined as the standard deviation of IOP measurements.


RESULTS
The percentage of patients with mean diurnal IOP <18 mm Hg and short-term (daily) IOP fluctuation ≤2 mm Hg was statistically significantly higher in the brimonidine-timolol group than in the brimonidine or timolol group at each follow-up visit (at month 12, brimonidine-timolol 43.0%; brimonidine 18.9%, timolol 33.5%, P ≤ .017). At each hour (8 AM, 10 AM, 3 PM, and 5 PM), the percentage of patients with mean IOP <18 mm Hg and long-term (intervisit) IOP fluctuation ≤2 mm Hg was statistically significantly higher with brimonidine-timolol than with brimonidine or timolol alone (at 8 AM, brimonidine-timolol 41.0%, brimonidine 11.3%, timolol 23.7%, P < .001).


CONCLUSIONS
Patients treated with fixed-combination brimonidine-timolol were more likely than patients treated with either brimonidine or timolol alone to achieve a combination of low mean IOP and low short-term (daily) or long-term (intervisit) IOP fluctuation.
Wills Eye Institute, Philadelphia, Pennsylvania 19107-5109, USA. gspaeth@willseye.org
George L
GL
Spaeth
Paula
P
Bernstein
Joseph
J
Caprioli
Rhett M
RM
Schiffman
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000068438:Brimonidine Tartrate; D002940:Circadian Rhythm; D004311:Double-Blind Method; D004338:Drug Combinations; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects* / Q000502:physiology; D009798:Ocular Hypertension / Q000188:drug therapy; D011810:Quinoxalines / Q000627:therapeutic use*; D013999:Timolol / Q000627:therapeutic use*; D014065:Tonometry, Ocular
D000959:Antihypertensive Agents; D004338:Drug Combinations; D011810:Quinoxalines; D000068438:Brimonidine Tartrate; D013999:Timolol