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Meta-analysis of 24-hour intraocular pressure studies evaluating the efficacy of glaucoma medicines.
Ophthalmology 2008; 115(7):1117-1122.e1O

Abstract

PURPOSE

To evaluate efficacy and safety data of currently available ocular hypotensive medicines derived from 24-hour studies, of similar design, in patients with primary open-angle glaucoma (POAG), exfoliative glaucoma, or ocular hypertension (OH).

DESIGN

Meta-analysis of published articles evaluating patients with POAG, exfoliative glaucoma, or OH.

METHODS

We included articles that were randomized, prospective, single- or double-masked, comparative studies of ocular hypotensive therapies over 24 hours. Each article selected contained an untreated baseline, >or=4-week treatment period, >/=20 patients per treatment arm, and >or=6 time points not spaced >5 hours apart and used Goldmann applanation or Tonopen tonometry (supine measurements) to measure intraocular pressure (IOP).

MAIN OUTCOME MEASURE

Twenty-four-hour IOP efficacy.

RESULTS

This analysis included 864 separate 24-hour treatment curves from 386 patients in 28 treatment arms from 11 studies. A statistical difference in the mean diurnal pressure decrease existed between monotherapy treatments for POAG/OH patients, with bimatoprost (29%) and travoprost (27%) showing the greatest 24-hour reduction (P = 0.026). Timolol 0.5% was less effective than latanoprost (24% vs. 19% reduction) but decreased the pressure at each night time point (P = 0.0003). Dorzolamide showed a 19% 24-hour pressure reduction and brimonidine 0.2% a 14% one. In exfoliative glaucoma patients, latanoprost and travoprost showed higher baseline and treatment pressures, although the pressure reductions (29% and 31%, respectively) were greater generally than observed with POAG/OH. An evening-dosed latanoprost/timolol fixed combination reduced the pressure 33%, and the dorzolamide/timolol fixed combination (DTFC), 26%. However, the power to detect a difference for this specific comparison was probably low, due to the limited number of patients (n = 20) in the DTFC group. A statistical difference between evening-dosed (24%) and morning-dosed (18%) latanoprost (P<0.0001) was noted, but not between evening (27%) and morning (26%) travoprost (P = 0.074). The mean reduction of night time points was statistically lower than day time points for latanoprost (P = 0.031), timolol (P = 0.032), and brimonidine (P = 0.050), but not for dorzolamide. Dorzolamide (P = 0.60), travoprost (P = 0.064), and bimatoprost (P = 0.057) did not demonstrate nighttime pressures lower than daytime ones. The mean reduction of night time points was statistically lower than that of day time points for latanoprost (P = 0.031), timolol (P = 0.032), and brimonidine (P = 0.050), but not for dorzolamide (P = 0.60), bimatoprost (P = 0.057), travoprost (P = 0.064).

CONCLUSIONS

Similar relative efficacies generally exist in various classes of ocular hypotensive agents during night and day hours.

Authors+Show Affiliations

PRN Pharmaceutical Research Network, LLC, Dallas, Texas, USA. info@prnorb.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis

Language

eng

PubMed ID

18082886

Citation

Stewart, William C., et al. "Meta-analysis of 24-hour Intraocular Pressure Studies Evaluating the Efficacy of Glaucoma Medicines." Ophthalmology, vol. 115, no. 7, 2008, pp. 1117-1122.e1.
Stewart WC, Konstas AG, Nelson LA, et al. Meta-analysis of 24-hour intraocular pressure studies evaluating the efficacy of glaucoma medicines. Ophthalmology. 2008;115(7):1117-1122.e1.
Stewart, W. C., Konstas, A. G., Nelson, L. A., & Kruft, B. (2008). Meta-analysis of 24-hour intraocular pressure studies evaluating the efficacy of glaucoma medicines. Ophthalmology, 115(7), pp. 1117-1122.e1.
Stewart WC, et al. Meta-analysis of 24-hour Intraocular Pressure Studies Evaluating the Efficacy of Glaucoma Medicines. Ophthalmology. 2008;115(7):1117-1122.e1. PubMed PMID: 18082886.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meta-analysis of 24-hour intraocular pressure studies evaluating the efficacy of glaucoma medicines. AU - Stewart,William C, AU - Konstas,Anastasios G P, AU - Nelson,Lindsay A, AU - Kruft,Bonnie, Y1 - 2008/02/20/ PY - 2007/03/08/received PY - 2007/09/07/revised PY - 2007/10/02/accepted PY - 2007/12/18/pubmed PY - 2008/7/17/medline PY - 2007/12/18/entrez SP - 1117 EP - 1122.e1 JF - Ophthalmology JO - Ophthalmology VL - 115 IS - 7 N2 - PURPOSE: To evaluate efficacy and safety data of currently available ocular hypotensive medicines derived from 24-hour studies, of similar design, in patients with primary open-angle glaucoma (POAG), exfoliative glaucoma, or ocular hypertension (OH). DESIGN: Meta-analysis of published articles evaluating patients with POAG, exfoliative glaucoma, or OH. METHODS: We included articles that were randomized, prospective, single- or double-masked, comparative studies of ocular hypotensive therapies over 24 hours. Each article selected contained an untreated baseline, >or=4-week treatment period, >/=20 patients per treatment arm, and >or=6 time points not spaced >5 hours apart and used Goldmann applanation or Tonopen tonometry (supine measurements) to measure intraocular pressure (IOP). MAIN OUTCOME MEASURE: Twenty-four-hour IOP efficacy. RESULTS: This analysis included 864 separate 24-hour treatment curves from 386 patients in 28 treatment arms from 11 studies. A statistical difference in the mean diurnal pressure decrease existed between monotherapy treatments for POAG/OH patients, with bimatoprost (29%) and travoprost (27%) showing the greatest 24-hour reduction (P = 0.026). Timolol 0.5% was less effective than latanoprost (24% vs. 19% reduction) but decreased the pressure at each night time point (P = 0.0003). Dorzolamide showed a 19% 24-hour pressure reduction and brimonidine 0.2% a 14% one. In exfoliative glaucoma patients, latanoprost and travoprost showed higher baseline and treatment pressures, although the pressure reductions (29% and 31%, respectively) were greater generally than observed with POAG/OH. An evening-dosed latanoprost/timolol fixed combination reduced the pressure 33%, and the dorzolamide/timolol fixed combination (DTFC), 26%. However, the power to detect a difference for this specific comparison was probably low, due to the limited number of patients (n = 20) in the DTFC group. A statistical difference between evening-dosed (24%) and morning-dosed (18%) latanoprost (P<0.0001) was noted, but not between evening (27%) and morning (26%) travoprost (P = 0.074). The mean reduction of night time points was statistically lower than day time points for latanoprost (P = 0.031), timolol (P = 0.032), and brimonidine (P = 0.050), but not for dorzolamide. Dorzolamide (P = 0.60), travoprost (P = 0.064), and bimatoprost (P = 0.057) did not demonstrate nighttime pressures lower than daytime ones. The mean reduction of night time points was statistically lower than that of day time points for latanoprost (P = 0.031), timolol (P = 0.032), and brimonidine (P = 0.050), but not for dorzolamide (P = 0.60), bimatoprost (P = 0.057), travoprost (P = 0.064). CONCLUSIONS: Similar relative efficacies generally exist in various classes of ocular hypotensive agents during night and day hours. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/18082886/Meta_analysis_of_24_hour_intraocular_pressure_studies_evaluating_the_efficacy_of_glaucoma_medicines_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(07)01076-7 DB - PRIME DP - Unbound Medicine ER -