Wc. Stewart et al., Brimonidine 0.2% versus dorzolamide 2% each given three times daily to reduce intraocular pressure, AM J OPHTH, 129(6), 2000, pp. 723-727
PURPOSE: To evaluate the efficacy and safety of brimonidine compared with d
orzolamide given three times daily as monotherapy in patients with primary
open-angle glaucoma or ocular hypertension,
METHODS: In a double-masked, multicenter, crossover comparison in 40 patien
ts, qualified patients were washed out from their previous medication and r
andomized to dorzolamide 2% or brimonidine 0.2% for the first 6-week treatm
ent period. Patients then were washed out for 2 weeks and started on the op
posite medication for the second 6-week period.
RESULTS: Baseline intraocular pressure for ail 40 subjects (76 eyes) was 24
.1 +/- 2.0 mm Hg. This study found that the 8:00 AM trough intraocular pres
sure after 6 weeks of therapy for dorzolamide was 20.7 +/- 3.1 mm Hg and fo
r brimonidine 20.8 +/- 3.2 mm Hg (P = .99). The peak intraocular pressure (
2 hours after dosing) for dorzolamide was 18.6 +/- 3.4 mm Hg: and for brimo
nidine 17.8 +/- 2.7 mm Hg (P = .10). Dorzolamide caused more stinging upon
instillation (P < .01) and brimonidine more itching (P = .01). No statistic
al differences existed between groups for systemic adverse events. Six pati
ents, all on brimonidine, were discontinued from a treatment period early.
Of these, two were discontinued for inadequate pressure control, two with d
izziness and fatigue, one with ocular pain, and one for lifestyle reasons (
P = .07).
CONCLUSIONS: This study found similar efficacy and safety between monothera
py treatment with dorzolamide or brimonidine when each was given three rime
s daily to patients with ocular hypertension or primary open-angle glaucoma
. (C) 2000 by Elsevier Science Inc, Ail rights reserved.