Wc. Stewart et al., The efficacy and safety of latanoprost 0.005% once daily versus brimonidine 0.2% twice daily in open-angle glaucoma or ocular hypertension, AM J OPHTH, 131(5), 2001, pp. 631-635
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.).