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Brimonidine tartrate 0.15%, dorzolamide hydrochloride 2%, and brinzolamide 1% compared as adjunctive therapy to prostaglandin analogs.

Abstract

OBJECTIVE

To compare the efficacy of brimonidine, dorzolamide, and brinzolamide in reducing intraocular pressure (IOP) when used as adjunctive therapy to a prostaglandin analog (PGA).

DESIGN

Randomized, controlled, investigator-masked, single-site, parallel-group clinical trial.

PARTICIPANTS

One hundred twenty eyes of 120 patients with open-angle glaucoma or ocular hypertension who had inadequate IOP control after at least 6 weeks of monotherapy with a once-daily PGA (bimatoprost, latanoprost, or travoprost).

INTERVENTION

Study eyes were assigned randomly to adjunctive treatment with thrice-daily brimonidine tartrate 0.15% (n = 41), dorzolamide hydrochloride 2% (n = 40), or brinzolamide 1% (n = 39) for 4 months.

MAIN OUTCOME MEASURES

Efficacy was evaluated by IOP measured at 10 am and 4 pm at baseline, month 1, and month 4.

RESULTS

The mean IOP at each hour at PGA-treated baseline was comparable among treatment groups. After initiation of adjunctive therapy, the mean IOP was lower and the mean change from baseline IOP was greater in the brimonidine group than in either the dorzolamide group or the brinzolamide group at 10 am and 4 pm at months 1 and 4 (P<0.001). After 4 months of adjunctive treatment, the mean IOP reduction from baseline at 10 am and 4 pm was 4.8 mmHg (21%) and 3.8 mmHg (19%) with brimonidine, 3.4 mmHg (16%) and 2.8 mmHg (14%) with dorzolamide, and 3.4 mmHg (16%) and 2.6 mmHg (13%) with brinzolamide (P<0.001 for brimonidine vs. dorzolamide and brinzolamide at each time point). Each of the study drugs was well tolerated, and all patients completed the study.

CONCLUSIONS

The addition of brimonidine to a PGA provided greater IOP lowering than the addition of either dorzolamide or brinzolamide. Further studies are needed to evaluate the relative long-term efficacy and tolerability of these medications as adjunctive therapy to a PGA.

FINANCIAL DISCLOSURE(S)

Proprietary or commercial disclosure may be found after the references.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Feinberg School of Medicine, Northwestern University, 233 East Erie, Chicago, IL 60611, USA. bournias@northwestern.edu

    Source

    Ophthalmology 116:9 2009 Sep pg 1719-24

    MeSH

    Aged
    Aged, 80 and over
    Amides
    Antihypertensive Agents
    Bimatoprost
    Brimonidine Tartrate
    Cloprostenol
    Drug Therapy, Combination
    Female
    Glaucoma, Open-Angle
    Humans
    Intraocular Pressure
    Latanoprost
    Male
    Middle Aged
    Ocular Hypertension
    Prospective Studies
    Prostaglandins F, Synthetic
    Quinoxalines
    Single-Blind Method
    Sulfonamides
    Thiazines
    Thiophenes
    Tonometry, Ocular
    Travoprost
    Treatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19592108

    Citation

    Bournias, Thomas E., and Jerry Lai. "Brimonidine Tartrate 0.15%, Dorzolamide Hydrochloride 2%, and Brinzolamide 1% Compared as Adjunctive Therapy to Prostaglandin Analogs." Ophthalmology, vol. 116, no. 9, 2009, pp. 1719-24.
    Bournias TE, Lai J. Brimonidine tartrate 0.15%, dorzolamide hydrochloride 2%, and brinzolamide 1% compared as adjunctive therapy to prostaglandin analogs. Ophthalmology. 2009;116(9):1719-24.
    Bournias, T. E., & Lai, J. (2009). Brimonidine tartrate 0.15%, dorzolamide hydrochloride 2%, and brinzolamide 1% compared as adjunctive therapy to prostaglandin analogs. Ophthalmology, 116(9), pp. 1719-24. doi:10.1016/j.ophtha.2009.03.050.
    Bournias TE, Lai J. Brimonidine Tartrate 0.15%, Dorzolamide Hydrochloride 2%, and Brinzolamide 1% Compared as Adjunctive Therapy to Prostaglandin Analogs. Ophthalmology. 2009;116(9):1719-24. PubMed PMID: 19592108.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Brimonidine tartrate 0.15%, dorzolamide hydrochloride 2%, and brinzolamide 1% compared as adjunctive therapy to prostaglandin analogs. AU - Bournias,Thomas E, AU - Lai,Jerry, Y1 - 2009/07/09/ PY - 2008/08/12/received PY - 2009/03/24/revised PY - 2009/03/27/accepted PY - 2009/7/14/entrez PY - 2009/7/14/pubmed PY - 2009/9/25/medline SP - 1719 EP - 24 JF - Ophthalmology JO - Ophthalmology VL - 116 IS - 9 N2 - OBJECTIVE: To compare the efficacy of brimonidine, dorzolamide, and brinzolamide in reducing intraocular pressure (IOP) when used as adjunctive therapy to a prostaglandin analog (PGA). DESIGN: Randomized, controlled, investigator-masked, single-site, parallel-group clinical trial. PARTICIPANTS: One hundred twenty eyes of 120 patients with open-angle glaucoma or ocular hypertension who had inadequate IOP control after at least 6 weeks of monotherapy with a once-daily PGA (bimatoprost, latanoprost, or travoprost). INTERVENTION: Study eyes were assigned randomly to adjunctive treatment with thrice-daily brimonidine tartrate 0.15% (n = 41), dorzolamide hydrochloride 2% (n = 40), or brinzolamide 1% (n = 39) for 4 months. MAIN OUTCOME MEASURES: Efficacy was evaluated by IOP measured at 10 am and 4 pm at baseline, month 1, and month 4. RESULTS: The mean IOP at each hour at PGA-treated baseline was comparable among treatment groups. After initiation of adjunctive therapy, the mean IOP was lower and the mean change from baseline IOP was greater in the brimonidine group than in either the dorzolamide group or the brinzolamide group at 10 am and 4 pm at months 1 and 4 (P<0.001). After 4 months of adjunctive treatment, the mean IOP reduction from baseline at 10 am and 4 pm was 4.8 mmHg (21%) and 3.8 mmHg (19%) with brimonidine, 3.4 mmHg (16%) and 2.8 mmHg (14%) with dorzolamide, and 3.4 mmHg (16%) and 2.6 mmHg (13%) with brinzolamide (P<0.001 for brimonidine vs. dorzolamide and brinzolamide at each time point). Each of the study drugs was well tolerated, and all patients completed the study. CONCLUSIONS: The addition of brimonidine to a PGA provided greater IOP lowering than the addition of either dorzolamide or brinzolamide. Further studies are needed to evaluate the relative long-term efficacy and tolerability of these medications as adjunctive therapy to a PGA. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/19592108/Brimonidine_tartrate_0_15_dorzolamide_hydrochloride_2_and_brinzolamide_1_compared_as_adjunctive_therapy_to_prostaglandin_analogs_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(09)00347-9 DB - PRIME DP - Unbound Medicine ER -