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Intraocular pressure-lowering effect of adding dorzolamide or latanoprost to timolol: a meta-analysis of randomized clinical trials.
Ophthalmology 2007; 114(1):40-6O

Abstract

OBJECTIVE

To estimate the intraocular pressure (IOP)-lowering effect of 2% dorzolamide or 0.005% latanoprost when added to 0.5% timolol.

DESIGN

Meta-analysis of randomized clinical trials.

PARTICIPANTS

Seventeen articles reporting on 19 study arms with 5 possible treatment combinations and 4 study arms serving as controls.

METHODS

Articles written in English, German, French, or Dutch and published up to December 2004 were identified in Medline, Embase, the Cochrane Controlled Trials Register, and references from relevant articles. For the article to be considered, over 85% of the patients had to have primary open-angle glaucoma or ocular hypertension. The pooled 1- to 3-month additional IOP-lowering effect after a run-in phase on timolol was calculated by performing meta-analysis using the random effects model.

MAIN OUTCOME MEASURES

Absolute and relative changes in IOP after run-in on timolol for peak moment, trough moment, or mean diurnal curve.

RESULTS

The pooled change from baseline [mean (95% confidence interval)] for 0.5% timolol varied from -0.7 mmHg (-1.2 to -0.2, for the mean diurnal curve) to -2.0 mmHg (-1.3 to -2.7, at peak). Pooled changes for 2% dorzolamide in concomitant use with 0.5% timolol were -4.1 mmHg (-4.4 to -3.8) at trough and -4.9 mmHg (-5.3 to -4.5) at peak. The fixed 2% dorzolamide and 0.5% timolol combination resulted in a pooled change of -3.8 mmHg (-4.2 to -3.4) at trough and -4.9 mmHg (-5.3 to -4.5) at peak. The concomitant use of 0.005% latanoprost and 0.5% timolol gave a pooled change from baseline of -6.0 mmHg (-6.8 to -5.2) at the mean diurnal curve. The fixed combination of 0.005% latanoprost and 0.5% timolol resulted in a mean change of -3.0 mmHg (-3.8 to -2.2) at the mean diurnal curve.

CONCLUSION

In this meta-analysis of clinical trials, the addition of dorzolamide or latanoprost further lowers IOP in eyes on timolol. This result may not be generalizable because these trials may have included nonresponders to timolol.

Authors+Show Affiliations

Department of Ophthalmology, Maastricht University Hospital, Maastricht, The Netherlands. cweb@soog.azm.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17070584

Citation

Webers, Carroll A B., et al. "Intraocular Pressure-lowering Effect of Adding Dorzolamide or Latanoprost to Timolol: a Meta-analysis of Randomized Clinical Trials." Ophthalmology, vol. 114, no. 1, 2007, pp. 40-6.
Webers CA, van der Valk R, Schouten JS, et al. Intraocular pressure-lowering effect of adding dorzolamide or latanoprost to timolol: a meta-analysis of randomized clinical trials. Ophthalmology. 2007;114(1):40-6.
Webers, C. A., van der Valk, R., Schouten, J. S., Zeegers, M. P., Prins, M. H., & Hendrikse, F. (2007). Intraocular pressure-lowering effect of adding dorzolamide or latanoprost to timolol: a meta-analysis of randomized clinical trials. Ophthalmology, 114(1), pp. 40-6.
Webers CA, et al. Intraocular Pressure-lowering Effect of Adding Dorzolamide or Latanoprost to Timolol: a Meta-analysis of Randomized Clinical Trials. Ophthalmology. 2007;114(1):40-6. PubMed PMID: 17070584.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraocular pressure-lowering effect of adding dorzolamide or latanoprost to timolol: a meta-analysis of randomized clinical trials. AU - Webers,Carroll A B, AU - van der Valk,Rikkert, AU - Schouten,Jan S A G, AU - Zeegers,Maurice P, AU - Prins,Martin H, AU - Hendrikse,Fred, Y1 - 2006/10/27/ PY - 2005/12/20/received PY - 2006/06/30/revised PY - 2006/07/04/accepted PY - 2006/10/31/pubmed PY - 2007/1/17/medline PY - 2006/10/31/entrez SP - 40 EP - 6 JF - Ophthalmology JO - Ophthalmology VL - 114 IS - 1 N2 - OBJECTIVE: To estimate the intraocular pressure (IOP)-lowering effect of 2% dorzolamide or 0.005% latanoprost when added to 0.5% timolol. DESIGN: Meta-analysis of randomized clinical trials. PARTICIPANTS: Seventeen articles reporting on 19 study arms with 5 possible treatment combinations and 4 study arms serving as controls. METHODS: Articles written in English, German, French, or Dutch and published up to December 2004 were identified in Medline, Embase, the Cochrane Controlled Trials Register, and references from relevant articles. For the article to be considered, over 85% of the patients had to have primary open-angle glaucoma or ocular hypertension. The pooled 1- to 3-month additional IOP-lowering effect after a run-in phase on timolol was calculated by performing meta-analysis using the random effects model. MAIN OUTCOME MEASURES: Absolute and relative changes in IOP after run-in on timolol for peak moment, trough moment, or mean diurnal curve. RESULTS: The pooled change from baseline [mean (95% confidence interval)] for 0.5% timolol varied from -0.7 mmHg (-1.2 to -0.2, for the mean diurnal curve) to -2.0 mmHg (-1.3 to -2.7, at peak). Pooled changes for 2% dorzolamide in concomitant use with 0.5% timolol were -4.1 mmHg (-4.4 to -3.8) at trough and -4.9 mmHg (-5.3 to -4.5) at peak. The fixed 2% dorzolamide and 0.5% timolol combination resulted in a pooled change of -3.8 mmHg (-4.2 to -3.4) at trough and -4.9 mmHg (-5.3 to -4.5) at peak. The concomitant use of 0.005% latanoprost and 0.5% timolol gave a pooled change from baseline of -6.0 mmHg (-6.8 to -5.2) at the mean diurnal curve. The fixed combination of 0.005% latanoprost and 0.5% timolol resulted in a mean change of -3.0 mmHg (-3.8 to -2.2) at the mean diurnal curve. CONCLUSION: In this meta-analysis of clinical trials, the addition of dorzolamide or latanoprost further lowers IOP in eyes on timolol. This result may not be generalizable because these trials may have included nonresponders to timolol. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/17070584/Intraocular_pressure_lowering_effect_of_adding_dorzolamide_or_latanoprost_to_timolol:_a_meta_analysis_of_randomized_clinical_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(06)00999-7 DB - PRIME DP - Unbound Medicine ER -