DORZOLAMIDE VERSUS PILOCARPINE AS ADJUNCTIVE THERAPIES TO TIMOLOL - ACOMPARISON OF PATIENT PREFERENCE AND IMPACT ON DAILY-LIFE

The purpose of this study was to compare 2% dorzolamide three times da ily with 2% pilocarpine four times daily to determine patient preferen ce, tolerability, and impact on daily life in patients concurrently re ceiving 0.5% timolol twice daily for treatment of elevated intraocular pressure (IOP). Seventy-five patients were enrolled in this 4-week, r andomized, two-period, crossover study. The Comparison of Ophthalmic M edications for Tolerability questionnaire was used to assess patient p reference and perception of side effects and activity limitations resu lting from the study medications. IOP measurements were obtained 2 hou rs after drops were instilled and visual field tests were performed at baseline and at the end of each crossover period. Significantly more patients receiving pilocarpine than dorzolamide reported adverse exper iences and discontinued the drug because of these adverse experiences. Similarly, patients reported more interference with their daily life because of side effects and activity limitations when receiving piloca rpine. Vision difficulties, accommodation difficulties, and brow ache were reported more often and were considered more bothersome by patien ts receiving pilocarpine. Bitter/unusual taste was reported more frequ ently and was considered more bothersome by patients receiving dorzola mide. Patients also reported missing fewer doses and were more satisfi ed with their medication when receiving dorzolamide. All of these chan ges were considered statistically significant. IOP control was not sig nificantly differ ent with either dorzolamide or pilocarpine. However, patients experienced a significant worsening of the mean defect of au tomated visual field examinations when receiving pilocarpine. At the e nd of the study, among patients with a preference, dorzolamide was pre ferred to pilocarpine by a ratio of more than 9:1. Overall, 81.9% of p atients preferred dorzolamide. Thus dorzolamide demonstrated better to lerability and less adverse impact on daily life than pilocarpine.