Bimatoprost: a member of a new class of agents, the prostamides, for glaucoma management

Bimatoprost, a synthetic analogue of endogenous prostamides, is in developm ent as a topical ocular hypotensive agent for the treatment of glaucoma and ocular hypertension. Prostamides are a newly discovered class of compounds that have been shown to have potent ocular hypotensive activity in the lab oratory. Bimatoprost mimics the endogenous prostamides by lowering intraocu lar pressure (IOP). Bimatoprost provides outstanding control of IOP through out the day, and a high percentage of patients receiving bimatoprost achiev e the low target pressures important for clinical success. In controlled cl inical trials, bimatoprost 0.03% given once daily has displayed efficacy su perior to timolol 0.5% given twice daily, the current standard for therapy. Analysis of pooled six month data from two large Phase III trials demonstr ated that mean IOP was consistently 2 - 3 mmHg lower with bimatoprost q.d. than with timolol b.i.d. Bimatoprost 0.03% q.d. has also been shown to prov ide significantly better diurnal IOP control than latanoprost 0.005% q.d., probably the most efficacious topical medication currently available. Patie nts receiving bimatoprost q.d. were more likely than timolol or latanoprost patients to achieve low target pressures. In all clinical evaluations, bim atoprost q.d. has been demonstrated to be safe and well-tolerated. Bimatopr ost will likely be available for clinical use in 2001 and it has great pote ntial to be superior to all other medications in IOP-lowering efficacy. It is anticipated that bimatoprost wilt have an important role in therapy for glaucoma and ocular hypertension.