Brimonidine tartrate 0.2% twice daily vs timolol 0.5% twice daily: 1-year results in glaucoma patients

PURPOSE: To compare the long-term efficacy and safety of brimonidine 0.2% t wice daily with timolol 0.5% twice daily in patients with glaucoma or ocula r hypertension. METHODS: Of the 926 patients enrolled in the study, 837 met the protocol en try criteria and received either brimonidine 0.2% twice daily (n = 466) or timolol 0.5% (n = 371) twice daily in each eye for 1 year. RESULTS: Brimonidine and timolol significantly reduced mean intraocular pre ssure (P < .001) from baseline levels at every scheduled follow-up visit, b oth at hour 2 (peak) and hour 12 (trough). At weeks 1 and 2 and months 3 an d 12, significantly greater mean decreases in intraocular pressure (P < .04 0) at peak were observed in patients treated with brimonidine than those tr eated with timolol, The mean intraocular pressure decrease at trough was si gnificantly greater for timolol than for brimonidine at each follow-up visi t (P < .001), With the exception of ocular allergy tin 11.5% of patients us ing brimonidine and less than 1% using timolol), fewer than 3% of patients in either treatment group withdrew from the study prematurely as a result o f a specific adverse event. Patients receiving timolol experienced signific ant decreases in heart rate (P < .001) from baseline at all follow-up visit s. No significant changes in heart rate were seen in patients treated with brimonidine. Neither medication produced clinically significant changes in blood pressure. CONCLUSION: Brimonidine is safe and effective in the long-term lowering of intraocular pressure in patients with glaucoma or ocular hypertension, with efficacy comparable to that of timolol but without a notable negative chro notropic effect on the heart. (C) 1999 by Elsevier Science Inc. All rights reserved.