A comparison of the intraocular pressure-lowering effect of 0.5% timolol maleate and the docosanoid derivative of a PGF(2 alpha) metabolite, 0.12% unoprostone, in subjects with chronic open-angle glaucoma or ocular hypertension

The efficacy of 0.5% timolol was compared with that of the prostaglandin de rivative unoprostone in maintaining control of intraocular pressure (IOP) i n subjects with chronic open angle glaucoma (COAG) or ocular hypertension ( OH) already responding satisfactorily to beta-blocker monotherapy. in a two -centre, double-masked, randomised parallel group study, 40 subjects were p laced on 0.5% timolol eyedrops twice daily or two weeks. They were then ran domised either to continue with 0.5% timolol or to switch to 0.12% unoprost one, applied twice daily for six weeks. IOP was measured at two-weekly inte rvals. The status of the conjunctiva, iris, cornea and anterior chamber was kept under observation. Ocular safety was monitored by measurements of vis ual acuity, and any systemic adverse events were recorded. After six weeks' treatment, there were no statistically significant differences in mean? ch ange from baseline IOP within or between treatment groups. For the subjects treated with unoprostone, mean IOP increased by 0.69 mm Hg (p = 0.368) whi le that of the timolol-treated subjects fell by 0.47 mm Hg (p = 0.287). The difference in mean IOP between groups was 1.16 mpn Hg (p = 0.211, 95% conf idence interval [CI] -0.69 to 3.02). The mast common complaint was a mild a nd transient burning sensation on instillation which occurred move frequent ly in the unoprostone group. In conclusion, an aqueous solution of 0.12% un oprostone isopropyl, applied topically to the eye twice daily for six weeks , was as effective as 0.5% timolol in maintaining control of OOP in subject s with chronic open angle glaucoma or ocular hypertenion. Both treatments w ere safe and well tolerated.