97th DOG Annual Meeting 1999
A COMPARISON OF LATANOPROST MONOTHERAPY TO DORZOLAMIDE COMBINED WITH TIMOLOL IN PATIENTS WITH GLAUCOMA AND OCULAR HYPERTENSION.
K.-H. Emmerich and the Latanoprost Study Group.
Glaucoma patients inadequately controlled on timolol might either be switched to monotherapy with another substance class or to a combination therapy, but under combination therapy the side effects of the two substances could occur as well as a possibly negative impact on compliance due to the more frequent application. This study compares the intraocular pressure (IOP) lowering effect of a once daily applied monotherapy with that of a modern combination therapy, both components applied twice daily.
Objective: To compare the effects on IOP by adding dorzolamide to timolol or by switching patients from timolol to latanoprost monotherapy in glaucoma patients inadequately controlled on timolol.
Patients: 183 patients with primary open angle glaucoma or capsular glaucoma with an IOP above 22 mmHg on treatment with one or two ocular hypotensive drugs, or patients with ocular hypertension with an IOP above 27 mmHg.
Study design: A three-month randomized, open-label, multicenter study.
After a 2-4 week run-in period on timolol, 5 mg/ml twice daily, the patients were randomized to treatment with latanoprost, 50 µg/ml once daily, or the combination of timolol, 5 mg/ml twice daily, and dorzolamide, 20 mg/ml twice daily.
Main outcome measures: The change in mean diurnal IOP after 3 months of treatment compared to baseline.
Results: Switching from timolol to latanoprost reduced mean diurnal IOP by 4.5 ± 0.2 mmHg (mean ± SEM, ANCOVA; 20%) and adding dorzolamide to timolol reduced mean diurnal IOP by 4.4 ± 0.2 mmHg (mean ± SEM, ANCOVA; 20%). No serious side effects were observed with either treatment.
Conclusions: A switch to latanoprost monotherapy is an alternative to combined treatment with two aqueous flow suppressors in patients insufficiently controlled on timolol alone.
Eye Clinic, Klinikum Darmstadt, Heidelberger Landstr. 379, D-64297 Darmstadt