title: Comparison of the effects of bimatoprost and a fixed combination of latanoprost and timolol on 24-hour blood and ocular perfusion pressures: the results of a randomized trial.
abstract: BACKGROUND
  To compare the effect of bimatoprost and the fixed combination latanoprost-timolol (LTFC) on 24-hour systolic (SBP) and diastolic (DBP) blood pressure and on 24-hour ocular perfusion pressure (OPP).
  
  
  METHODS
  200 patients with glaucoma or ocular hypertension, controlled on the unfixed combination of latanoprost and timolol or eligible for dual therapy being not being fully controlled on monotherapy were enrolled in a randomized, double-masked, placebo-controlled, multicentre clinical trial. They were randomized to LTFC (8 a.m.) or bimatoprost (8 p.m.) and received 24-hour IOP curve at baseline, 6 and 12 weeks (supine and sitting position IOPs were recorded at 8 p.m., midnight, 5 a.m., 8a.m., noon and 4 p.m.). Holter 24-hour blood pressure curve was obtained between weeks 2 and 12. SBP, DBP, OPP were calculated and compared with ANOVA. Rates of diastolic OPP (DPP)≤50, ≤40, ≤30 mmHg in the 2 groups were calculated and compared using Fisher's test.
  
  
  RESULTS
  Mean baseline SBP and DBP were 136.5±18.3 vs 134.2±20.1 mmHg (p=0.1) and 79.1±10.2 vs 78.2±10.1 mmHg (p=0.4) in the bimatoprost and LTFC groups respectively. Holter SBP was significantly higher for bimatoprost (135.1 mmHg vs 128.1 mmHg, p=0.04), while no statistically significant difference in DBP was found. DPP was similar in the 2 groups, and proportions of patients with at least one value of the 24-hour curve≤50, ≤40, ≤30 mmHg were 94%, 86%, 41% respectively.
  
  
  CONCLUSIONS
  Bimatoprost and LTFC had similar DBPs and OPPs; SBP was significantly lower with LTFC. In this study, the percentage of "dippers" was considerably higher than the one described in previous studies on the role of perfusion pressure in glaucoma.
  
  
  BACKGROUND
  NCT02154217, May 21, 2014.
authors.affiliation: Clinica Oculistica, Dipartimento di Medicina, Chirurgia e Odontoiatria, Università di Milano, Ospedale San Paolo, Via di Rudinì 8, 20142, Milan, Italy. luca.rossetti@unimi.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Rossetti
authors.affiliation: Clinica Oculistica, Dipartimento di Medicina, Chirurgia e Odontoiatria, Università di Milano, Ospedale San Paolo, Via di Rudinì 8, 20142, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Sacchi
authors.affiliation: Department of Ophthalmology, University of Thessaly School of Medicine, Larissa, Greece.
authors.forename: Costas H
authors.initials: CH
authors.lastname: Karabatsas
authors.affiliation: Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, American Hellenic Educational Progressive Association (AHEPA) Hospital, Thessaloniki, Greece.
authors.forename: Fotis
authors.initials: F
authors.lastname: Topouzis
authors.affiliation: Anthea Hospital, GVM Care and Research, Bari, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Vetrugno
authors.affiliation: DSCMT Università di Roma 'Tor Vergata'; IRCCS Fondazione G.B. Bietti, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Centofanti
authors.affiliation: University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Boehm
authors.affiliation: Augenklinik der Otto von Guericke Universität Magdeburg, Magdeburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Vorwerk
authors.affiliation: Department of Ophthalmology, University Hospital Basel, University Basel, Basel, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Goldblum
authors.affiliation: Clinica Oculistica, Dipartimento di Medicina, Chirurgia e Odontoiatria, Università di Milano, Ospedale San Paolo, Via di Rudinì 8, 20142, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fogagnolo
mesh_terms: D000328:Adult; D000368:Aged; D000577:Amides / Q000494:pharmacology*; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000494:pharmacology*; D000069580:Bimatoprost; D001794:Blood Pressure / Q000187:drug effects*; D003008:Cloprostenol / Q000031:analogs & derivatives* / Q000494:pharmacology; D004311:Double-Blind Method; 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; D009798:Ocular Hypertension / Q000188:drug therapy*; D011461:Prostaglandins F, Synthetic / Q000494:pharmacology*; D013999:Timolol / Q000494:pharmacology*
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D011461:Prostaglandins F, Synthetic; D003008:Cloprostenol; D000077338:Latanoprost; D013999:Timolol; D000069580:Bimatoprost