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Study: switching from timolol to latanoprost is as effective as combination therapy
Adding latanoprost to timolol also achieves an IOP reduction of 25%.
DIJON, France — Switching from timolol to latanoprost reduced intraocular pressure in glaucoma and ocular hypertension patients by 25% in a recent study. The study also reported that adding latanoprost to timolol achieved a similar IOP reduction.
Although IOP can be reduced with adrenergic beta-receptor blockers alone or in combination, for some patients, the effect of the treatment diminishes with time and is eventually considered a failure, according to the authors. In an effort to alleviate this problem, most studies have focused on comparisons between Xalatan (latanoprost, Pharmacia) and timolol or the two drugs in combination.
“This study shows that switching to latanoprost in patients poorly controlled with beta-blockers is of benefit,” said primary investigator Alain Bron, MD, a professor of ophthalmology at the Hopital General here. “There are fewer adverse effects, better compliance, and patients get better control of their IOP with fewer drops. This line of research is going toward latanoprost as a first-line therapy.”
The study was recently published in Acta Ophthalmologica Scandinavica.
Study design
Dr. Bron and colleagues conducted a 6-week, double-masked, randomized, multicenter study with 53 patients with primary open-angle glaucoma, capsular glaucoma or ocular hypertension. All of the patients had an IOP of at least 21 mm Hg on adrenergic beta-receptor blocker therapy. After a run-in period of at least 2 weeks on timolol (5 mg/mL twice daily), patients were randomized to one of three groups.
The patients were supplied with two identical bottles, one labeled “morning/evening” and one labeled “evening.” One group received timolol (5 mg/mL twice daily) and latanoprost (50 µg/mL in the evening), one group received timolol twice daily and placebo in the evening and one group received placebo twice daily and latanoprost in the evening. The eye drops were applied at 9 a.m. and 9 p.m. with 5 minutes between the two evening drops. Treatment efficacy was evaluated by comparing IOP at baseline and after 6 weeks of treatment.
Significant IOP reduction
Overall, as shown in the table, in both the latanoprost/placebo and combination groups, a significant IOP reduction of approximately 25% was achieved compared to the timolol/placebo group (P <>
Dr. Bron noted that the shift in treatment strategy should also result in larger cost savings.
“Most changes of the treatment — and consequently control visits — are made during the first year. An adequate control very early is definitely an advantage. Patients use fewer drops, it is cheaper and achieves better control of the disease,” he said.
For Your Information:Reference:
- Alain Bron, MD, can be reached at the Department of Ophthalmology, Hopital General Dijon, France; (33) 380-293-765; fax: (33) 380-293-589; e-mail: bronalain@wanadoo.fr. Dr. Bron is a paid consultant for Pharmacia.
- Pharmacia can be reached at 100 Route 206 North, Peapack, NJ 07977; (908) 901-8592.
- Bron AM, Denis P, et al. Additive IOP-reducing effect of latanoprost in patients insufficiently controlled on timolol. Acta Ophthalmologica Scandinavica. 2001;79:289-293.