April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Prostaglandin Analogues (PGAs) And Timolol Fixed Combination (Fc) Vs. Extemporaneous Combination (Ec) Or Monotherapy (Mt) In The Treatment Of Primary Open-angle Glaucoma (POAG) And Ocular Hypertension (OHT): A Systemtic Review And Meta-analysis
Author Affiliations & Notes
  • Luciano Quaranta
    Ophthalmology-Glaucoma Unit, University of Brescia, Brescia, Italy
  • Ivano Riva
    Ophthalmology-Glaucoma Unit, University of Brescia, Brescia, Italy
  • Andrea Russo
    Ophthalmology-Glaucoma Unit, University of Brescia, Brescia, Italy
  • Daniela Garavaglia
    Laboratory of Clinical Trials, Department of Oncology, Pharmacological Research Institute Mario Negri, Milan, Italy
  • Elena Biagioli
    Laboratory of Clinical Trials, Department of Oncology, Pharmacological Research Institute Mario Negri, Milan, Italy
  • Eliana Rulli
    Laboratory of Clinical Trials, Department of Oncology, Pharmacological Research Institute Mario Negri, Milan, Italy
  • Andreas Katsanos
    Ophthalmology-Glaucoma Unit, University of Brescia, Brescia, Italy
  • Davide Poli
    Laboratory of Clinical Trials, Department of Oncology, Pharmacological Research Institute Mario Negri, Milan, Italy
  • Stefano Miglior
    Ophthalmology, University of Milano Bicocca, Monza (MI), Italy
  • Footnotes
    Commercial Relationships  Luciano Quaranta, None; Ivano Riva, None; Andrea Russo, None; Daniela Garavaglia, None; Elena Biagioli, None; Eliana Rulli, None; Andreas Katsanos, None; Davide Poli, None; Stefano Miglior, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 215. doi:
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      Luciano Quaranta, Ivano Riva, Andrea Russo, Daniela Garavaglia, Elena Biagioli, Eliana Rulli, Andreas Katsanos, Davide Poli, Stefano Miglior; Prostaglandin Analogues (PGAs) And Timolol Fixed Combination (Fc) Vs. Extemporaneous Combination (Ec) Or Monotherapy (Mt) In The Treatment Of Primary Open-angle Glaucoma (POAG) And Ocular Hypertension (OHT): A Systemtic Review And Meta-analysis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):215.

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Abstract

Purpose: : PGAs are the first-choice drugs for the treatment of POAG and OHT. They are administered as Mt or as Fc or Ec with Timolol, a topical beta-blocker. Aim of this meta-analysis was to combine the results of the trials comparing the efficacy of Fc of Timolol and PGAs vs. Ec or vs. Mt.

Methods: : MEDLINE and EMBASE were searched for articles published until May 2010. Randomized, controlled trials, comparing treatment with Timolol and PGAs Fc vs. Ec or vs. Mt in patients with POAG or OHT were considered eligible. Quality of studies was assessed using a modified Delphi list, whose score ranges from -15 to +15. The primary efficacy endpoint was the mean difference (MD) between arms of the diurnal intraocular pressure (IOP) reduction from baseline. The pooled estimates were calculated using random effects.

Results: : Out of 855 retrieved articles, 15 were eligible accounting for a total of 22 comparisons: 18 assessing Fc vs. Mt, 4 Fc vs. Ec. The median quality score was 12 (range 5-15). Fc was more effective than both its components in Mt: Fc vs. Mt with Timolol (MD=-2.42, 95%CI -2.99,-1.85); Fc vs. Mt with PGAs (MD=-1.22, 95%CI -1.84,-0.59). When considering the type of PGAs given as Mt, the difference in efficacy between Fc and Latanoprost (MD=-1.21, 95%CI -1.75,-0.66) was smaller than in the comparison between Fc and Travoprost (MD=-2.14, 95%CI -3.05,-1.24). The only trial comparing Fc vs. Mt with Bimatoprost showed no significant difference (MD=-0.20, 95%CI -0.69,0.29). Moreover, the comparison between Fc and Ec showed that Fc is less effective in reducing IOP than Ec (MD=0.76, 95%CI 0.34, 1.17).

Conclusions: : The results of this meta-analysis suggest that Fc are more effective than Mt, and Ec seems to have a greater extent of IOP reduction when compared with Fc.

Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • intraocular pressure • drug toxicity/drug effects 
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