Diurnal IOP control with bimatoprost versus latanoprost in exfoliative glaucoma: a crossover, observer-masked, three-centre study

Abstract

Aim: To evaluate the diurnal intraocular pressure (IOP) control and safety of bimatoprost versus latanoprost in exfoliative glaucoma (XFG). Methods: One eye of 129 consecutive patients with XFG (mean (SD) age 66.5 (8.3) years) was included in this prospective, observer-masked, three-centre, crossover comparison. After a 4-6 week medicine-free period patients were randomised to bimatoprost or latanoprost monotherapy for 3 months. Patients were then switched to the opposite treatment for another 3 months. At the end of the washout and the treatment periods diurnal IOP was measured at 0800, 1300, and 1800. Results: At baseline the IOP (mean (SD)) was 28.0 (4.0), 26.9 (3.6), and 25.9 (3.6) mm Hg, at the three time points, respectively. Both treatments significantly reduced mean diurnal IOP at month 3. Mean diurnal IOP was 26.9 (3.5) mm Hg at baseline, 17.6 (3.3) mm Hg with bimatoprost, and 18.6 (3.6) mm Hg with latanoprost (p,0.0001). Furthermore, lower IOP values were obtained with bimatoprost at all time points (17.9 (3.4), 17.3 (3.3), and 17.6 (3.5) mm Hg, respectively) compared with latanoprost (18.7 (3.6), 18.5 (3.6), and 18.6 (4.1) mm Hg, respectively). The corresponding mean differences (0.8, 1.1, and 1.0 mm Hg, respectively) were all significant (p,0.001 for each comparison). Significantly more patients with XFG obtained a target diurnal IOP ,17 mm Hg with bimatoprost than with latanoprost, 55/123 (45%) v 34/123 (28%); (p = 0.001), and significantly fewer patients were non-responders with bimatoprost than with latanoprost (5 v 13, p = 0.021). More patients reported at least one adverse event with bimatoprost than with latanoprost (58 v 41 at 3 months; p = 0.0003). Conclusion: This crossover study suggests that better diurnal IOP control is obtained with bimatoprost than with latanoprost in patients with XFG.

Bimatoprost/timolol fixed combination vs latanoprost/timolol fixed combination in open-angle glaucoma patients

“…In a study by Konstas et al 19 the IOP-lowering efficacy of bimatoprost and latanoprost was evaluated. In this crossover 3-month clinical study, bimatoprost provided a significantly greater IOP reduction for all time points and for the diurnal curve after 3 months of treatment.…”

Preservative-free versus preserved latanoprost eye drops in patients with open-angle glaucoma or ocular hypertension

“…Topical prostaglandin analogs, which decrease the intraocular pressure (IOP) and reduce the rate of visual field progression 3 , consequently reducing the rates of glaucoma surgery 4,5 , are usually the first choice for medical management of primary open-angle glaucoma and ocular hypertension 6,7 . Of the common topical prostaglandin analogues used for glaucoma treatment, latanoprost is one of the most widely prescribed due to its favorable benefit-risk ratio [8][9][10] and compares favorably in terms of IOP reduction with other widely used therapeutic classes such as beta-blockers 11 . Many ophthalmic solutions, including prostaglandin-containing eye drops contain benzalkonium chloride (BAK), the most commonly used ocular preservative.…”

Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma

“…41 PXFG patients typically have an excellent response to prostaglandin analogues. 42 The use of miotics has some theoretical advantage for PXFG patients.…”