Therapeutic success of latanoprost 0.005% compared to brimonidine 0.2% in patients with open-angle glaucoma or ocular hypertension

The purpose of this study was to evaluate the success rate ofmonotherapy wi th latanoprost 0.005% once daily versus brimonidine 0.2% twice daily in pat ients with open-angle glaucoma or ocular hypertension. Patients who were prescribed latanoprost or brimonidine as monotherapy were included in this study, and their consecutive charts were retrospectively reviewed. The primary efficacy variable was success of therapy, defined as a reduction in intraocular pressure greater than or equal to 3 mm Hg withou t an adverse event leading to discontinuation over a potential of six month s of therapy. We included 157 patients in this study. In the latanoprost group, 64 of 92 (70%) were considered successes; 26 of 65 (40%) were successful with brimon idine (P < 0.001). Nine failed brimonidine therapy, and one latanoprost, be cause of an adverse event, and the rest failed because of inadequate intrao cular pressure response. The change from baseline in intraocular pressure w as significantly greater with latanoprost (mean +/- S.D., 21.6 +/- 5.1 to 1 7.1 +/- 3.3 mm Hg) than brimonidine (23.7 +/- 5.6 to 21.9 +/- 5.7 mm Hg) (P = 0.001). Overall, 52 (80%) brimonidine- and 41 (45%) latanoprost-treated patients required additional visit(s) to adjust therapy to further lower in traocular pressure or to assess an adverse event (P < 0.001). In conclusion, latanoprost more likely provides a successful response to th erapy than brimonidine when used as monotherapy in primary open-angle glauc oma or ocular hypertensive patients.