24-hour efficacy of the bimatoprost-timolol fixed combination versus latanoprost as first choice therapy in subjects with high-pressure juvanile-onset open-angle glaucoma.

Abstract

Purpose: To compare the 24-h efficacy of bimatoprost-timolol fixed combination (BTFC) administered once in the evening versus that of latanoprost when employed as first choice therapy in high-pressure JOAG patients.

Methods: A prospective, observer-masked, single centre, crossover comparison study. We enrolled consecutive patients with either newly diagnosed juvanile ocular hypertension, or early-to-moderate juvanile glaucoma, that had not been previously treated and exhibited a mean morning IOP >29 mm Hg requiring significant IOP reduction with medical therapy to obtain the desired target pressure. Patients were enrolled to one of the two study treatments (latanoprost or BTFC) according to a randomisation list.<br /> Qualified patients underwent therapy with each medication for at least 3 months (±2 weeks). At the end of the first therapy period, all subjects had a treated 24-h IOP assessment. All subjects were then switched for Period 2 to the opposite therapy regimen and at the end of this 3-month period they underwent a third 24-h IOP curve with identical methodology. Patients underwent 24-h IOP monitoring with Goldmann applanation tonometry in a sitting position.

Results: Overall 39 patients (14 m, 25 f, mean age 31 ± 5 years). The mean untreated 24-h baseline IOP was 31.7 ± 3.7 mm Hg. Both medications reduced pressure significantly at each time point and for the mean, peak, trough and fluctuation of 24-h IOP when compared with untreated baseline (p<0.001 for all comparisons). Specifically, latanoprost reduced the mean 24-h IOP by 7.9 mm Hg (24.1%), whereas BTFC reduced 24-h IOP significantly more by 13.9 mm Hg (40.6%). The difference in IOP reduction between the two treatments was significant (p<0.001).

Conclusions: The present study suggests that BTFC is more efficacious than latanoprost in reducing 24-h IOP in juvanile ocular hipertension/JOAG patients with high baseline IOP over the short-term.