Korean J Ophthalmol.  2014 Oct;28(5):399-407. 10.3341/kjo.2014.28.5.399.

Comparing the Efficacy of Latanoprost (0.005%), Bimatoprost (0.03%), Travoprost (0.004%), and Timolol (0.5%) in the Treatment of Primary Open Angle Glaucoma

Affiliations
  • 1Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, India. drdmishra12@yahoo.com
  • 2Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

Abstract

PURPOSE
To compare the efficacy and safety of latanoprost, bimatoprost, travoprost and timolol in reducing intraocular pressure (IOP) in patients with primary open angle glaucoma.
METHODS
This was a prospective study conducted at a tertiary-care centre. One hundred and forty patients with newly diagnosed primary open angle glaucoma were randomly assigned to treatment with latanoprost (0.005%), bimatoprost (0.03%), travoprost (0.004%) or timolol gel (0.5%); 35 patients were assigned to each group. All patients were followed for 2, 6, and 12 weeks. The main outcome measure studied was the change in IOP at week 12 from the baseline values. Safety measures included recording of adverse events.
RESULTS
The mean IOP reduction from baseline at week 12 was significantly more with bimatoprost (8.8 mmHg, 35.9%) than with latanoprost (7.3 mmHg, 29.9%), travoprost (7.6 mmHg, 30.8%) or timolol (6.7 mmHg, 26.6%) (ANOVA and Student's t-tests, p < 0.001). Among the prostaglandins studied, bimatoprost produced a maximum reduction in IOP (-2.71; 95% confidence interval [CI], -2.25 to -3.18) followed by travoprost (-1.27; 95% CI, -0.81 to -1.27) and latanoprost (-1.25; 95% CI, -0.79 to -1.71); these values were significant when compared to timolol at week 12 (Bonferroni test, p < 0.001). Latanoprost and travoprost were comparable in their ability to reduce IOP at each patient visit. Ocular adverse-events were found in almost equal proportion in patients treated with bimatoprost (41.3%) and travoprost (41.9%), with a higher incidence of conjunctival hyperemia (24.1%) seen in the bimatoprost group. Timolol produced a significant drop in heart rate (p < 0.001) at week 12 when compared to the baseline measurements.
CONCLUSIONS
Bimatoprost showed greater efficacy when compared to the other prostaglandins, and timolol was the most efficacious at lowering the IOP. Conjunctional hyperemia was mainly seen with bimatoprost. However, the drug was tolerated well and found to be safe.

Keyword

Primary open angle glaucoma; Prostaglandins; Timolol

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Antihypertensive Agents/adverse effects/*therapeutic use
Bimatoprost/adverse effects/therapeutic use
Blood Pressure/drug effects
Female
Glaucoma, Open-Angle/*drug therapy/physiopathology
Heart Rate/drug effects
Humans
Intraocular Pressure/drug effects
Male
Middle Aged
Prostaglandins F, Synthetic/adverse effects/therapeutic use
Timolol/adverse effects/therapeutic use
Tonometry, Ocular
Travoprost/adverse effects/therapeutic use
Treatment Outcome
Visual Acuity/drug effects
Visual Field Tests
Visual Fields/drug effects
Antihypertensive Agents
Bimatoprost
Prostaglandins F, Synthetic
Travoprost
Timolol

Figure

  • Fig. 1 Flow of patients at study visits. IOP = intraocular pressure; CCT = centeral corneal thickness; BP = blood pressure. *Excluded from analysis.

  • Fig. 2 Mean intraocular pressure at different time points in each study group.

  • Fig. 3 Mean intraocular pressure reductions at week 12 in each study group.

  • Fig. 4 Percent reduction of mean intraocular pressure at week 12 in each study group.


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