The efficacy and safety of latanoprost 0.005% once daily versus brimonidine 0.2% twice daily in open-angle glaucoma or ocular hypertension

PURPOSE: To evaluate the efficacy and safety of latano prost 0.005% given t opically every evening versus brimonidine 0.2% given topically twice daily in primary open-angle glaucoma or ocular hypertensive patients, METHODS: This was a multicenter, crossover, doublemasked comparison. After a 28-day treatment-free period, patients with primary open-angle glaucoma o r ocular hypertension were randomized for 6 weeks to brimonidine or latanop rost and then crossed over to the opposite treatment, At baseline and after each treatment period, patients underwent intraocular pressure measurement s every 2 hours from 08:00 to 20:00, RESULTS: In 33 patients the mean baseline trough (08:00) was 23.2 +/- 2.1 m m Hg and the diurnal curve pressure was 19.8 +/- 2.7 mm Hg, The trough and diurnal intraocular pressures for brimonidine were 19.6 +/- 3.4 mm Hg and 1 7.6 +/- 2.2 mm Hg, respectively. Brimonidine statistically reduced the pres sure from baseline at each time point except hours 10 and 12 (P =.14 and P = .21, respectively). For latanoprost, the trough and diurnal pressures wer e 16.2 +/- 2.9 mm Hg and 15.4 +/- 2.5 mm Hg, respectively, and the pressure was statistically reduced at each time point (P < .001) and for the diurna l curve (P < ,001), When compared directly, the intraocular pressure level for latanoprost was lower than brimonidine for the diurnal pressure and at each time point (P < .05), One patient was discontinued early from latanopr ost treatment because of eyelid swelling; also, latanoprost caused more hyp eremia than brimonidine (P =.04). CONCLUSION: This study suggests latanoprost dosed daily in the evening stat istically reduces intraocular pressure more during daytime and evening hour s than brimonidine dosed twice daily. Brimonidine may not consistently decr ease the pressure 10 and 12 hours past dosing from nontreated levels. (C) 2 001 by Elsevier Science Inc. All rights reserved.).