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S. Tsironi, A. G. P. Konstas, M. I. Pikilidou, D. Mikropoulos, V. P. Kozobolis, A. N. Lasarides, W. C. Stewart; 24-Hour Intraocular Pressure and Blood Pressure Control With Latanoprost/Timolol Maleate Fixed Combination QPM and Timolol Maleate BID in Primary Open Angle Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5565.
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To evaluate intraocular pressure (IOP) and blood pressure (BP) control in primary open-angle glaucoma patients (POAG) before and after therapy with timolol bid and latanoprost/timolol fixed combination (LTFC) qpm.
Randomized, observer-masked, placebo-controlled, crossover study that investigating IOP and BP of POAG patients without systemic hypertension. Following a 6-week washout period patients underwent baseline assessment of IOP and BP. Patients were then randomized to either LTFC qpm (8 PM) and placebo qam (8 AM) or timolol bid (8 AM and 8 PM). After 2 months on the first treatment patients were crossed over to the opposite treatment for an additional 2 months. Patients underwent 24-hour IOP curves by Goldmann applanation tonometry at 6 AM, 10 AM, 2 PM, 6 PM, 10 PM and 2 AM. BP was evaluated every 30 minutes during waking hours and every hour while asleep (Spacelabs 90217 ambulatory BP monitor).
28 POAG patients were included with an average 24-hour baseline IOP of 26.3±2.4 mm Hg and an average baseline mean BP of 90.9±7.6 mm Hg. Following 2 months of treatment no statistical difference existed between untreated and treated values for all BP parameters during the daytime or nighttime periods and no differences were detected between the 2 drugs for all BP parameters evaluated. LTFC did show superior IOP reduction for mean 24-hour IOP and at all time points compared with timolol (mean 24-hour IOP difference -2.6 mm Hg, P<0.0001).
This 24-hour study could not detect a clinically important, or statistically significant, impact of timolol or LTFC upon the BP parameters of POAG patients without systemic hypertension. LTFC had significantly better 24-hour IOP lowering efficacy than timolol.
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