Brimonidine 0.2% vs unoprostone 0.15% both added to timolol maleate 0.5% given twice daily to patients with primary open-angle glaucoma or ocular hypertension

Sharpe, Elizabeth D.; Henry, Charles; Mundorf, Thomas K.; Day, Douglas G.; Stewart, Jeanette A.; Jenkins, Jessica N.; Stewart, William C.

doi:10.1038/sj.eye.6701392

Cited by 6 publications

(2 citation statements)

References 22 publications

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“…In addition, adjunctive therapy between these medicines was not evaluated. Brimonidine has been shown to be effective throughout the 12-hour diurnal curve when given twice daily and added to timolol, and may have improved its late afternoon performance against unoprostone if both had been added to timolol maleate (Sharpe et al 2004). Further study may clarify the advantages and disadvantages of brimonidine versus unoprostone in the treatment of ocular hypertension or glaucoma.…”

Section: Discussionmentioning

confidence: 99%

The safety and efficacy of unoprostone 0.15% versus brimonidine 0.2%

Stewart

Day

et al. 2004

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To compare the efficacy and safety of unoprostone versus brimonidine both given twice daily in ocular hypertensive or primary open-angle glaucoma subjects. Methods: After a 1-month washout period a baseline diurnal curve was measured every 2 hours from 08 : 00 hours (trough) to 20 : 00 hours in subjects with a trough intraocular pressure (IOP) and the pressure 24 mmHg. Qualified subjects were randomized to either brimonidine or unoprostone. After 6 weeks of treatment the period 1 diurnal curve was performed. Subjects were then switched to the opposite treatment for 6 weeks and the period 2 diurnal curve was performed. Results: A total of 33 subjects were included in this study. In the brimonidinetreated group the trough IOP 20.1 AE 2.8 mmHg was reduced from baseline up to 8 hours after dosing. In the unoprostone-treated group the trough IOP was 19.5 AE 3.0 mmHg, which was statistically equal to that of brimonidine (p ¼ 0.21), was reduced from baseline for 12 hours after dosing. Brimonidine decreased the IOP statistically more than unoprostone at 10 : 00 and 12 : 00 hours (p < 0.0001 and p ¼ 0.02, respectively), while unoprostone reduced the IOP more than brimonidine at 18 : 00 and 20 : 00 hours (p ¼ 0.002 and p ¼ 0.05, respectively). Safety levels were similar between groups, but unoprostone caused more ocular stinging than brimonidine (p ¼ 0.008). Conclusion: This study suggests that twice daily brimonidine demonstrates a statistically greater peak reduction in IOP than unoprostone. However, unoprostone, but not brimonidine, decreased IOP over the complete 12-hour daytime dosing cycle.

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Section: Discussionmentioning

confidence: 99%

The safety and efficacy of unoprostone 0.15% versus brimonidine 0.2%

Stewart

Day

et al. 2004

Acta Ophthalmologica Scandinavica

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“…67–69 In a 12-week, multicenter, double-masked, randomized trial of 146 patients comparing unoprostone, brimonidine, and dorzolamide when added to timolol, Hommer et al found comparable efficacy in mean diurnal IOP reduction between all groups, with each adjunctive agent producing an additional drop in IOP of 2–3 mmHg from a timolol-treated baseline (see Figure 3). 67 Similar results were found in two other studies comparing unoprostone, brimonidine, and dorzolamide as adjunctive therapy with timolol 68,69. A study by Saito et al involving 52 patients with primary open-angle glaucoma found no additional IOP-lowering effect when unoprostone was added to latanoprost following 12 weeks of therapy 53…”

Section: Efficacymentioning

confidence: 99%

An evidence-based review of unoprostone isopropyl ophthalmic solution 0.15% for glaucoma: place in therapy

Fung¹,

Whitson

2014

OPTH

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Glaucoma is a progressive, neurodegenerative optic nerve disease that can cause significant visual morbidity and affects over 60 million people worldwide. The only known modifiable risk factor for glaucoma at this time is elevated intraocular pressure (IOP), which may be treated with medications, laser therapy, and/or incisional surgery. Topical ocular medications are commonly used as first-line therapy for glaucoma, although side effects may limit their use. Unoprostone is a novel 22-carbon ocular hypotensive agent that may be advantageous in treating some patients with open angle glaucoma or ocular hypertension. Unlike the 20-carbon prostanoids, such as latanoprost, that lower IOP primarily through an increase in uveoscleral outflow, unoprostone may lower IOP through increased aqueous outflow via the conventional trabecular meshwork pathway. Although not as efficacious as other prostanoids, unoprostone is effective for IOP reduction both as monotherapy and adjunctive therapy with timolol. Unoprostone has decreased affinity for the prostaglandin F2α receptor, which may explain its well tolerated ocular and systemic side effect profile compared with other prostanoids.

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Use of a Bayesian Network to Predict the Nighttime Intraocular Pressure Peak from Daytime Measurements

Nordmann¹,

Berdeaux

2007

Clinical Therapeutics

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Brimonidine 0.2% vs unoprostone 0.15% both added to timolol maleate 0.5% given twice daily to patients with primary open-angle glaucoma or ocular hypertension

Cited by 6 publications

References 22 publications

The safety and efficacy of unoprostone 0.15% versus brimonidine 0.2%

The safety and efficacy of unoprostone 0.15% versus brimonidine 0.2%

An evidence-based review of unoprostone isopropyl ophthalmic solution 0.15% for glaucoma: place in therapy

Use of a Bayesian Network to Predict the Nighttime Intraocular Pressure Peak from Daytime Measurements

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