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J. Bacharach, J. Caprioli, C.-C. Liu, A. Batoosingh; Randomized, Investigator-Masked Study Comparing the Efficacy and Tolerability of Bimatoprost and Latanoprost in Patients After Initial Latanoprost Treatment. Invest. Ophthalmol. Vis. Sci. 2010;51(13):166.
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To evaluate the efficacy and safety of replacing latanoprost with bimatoprost versus remaining on latanoprost in patients with glaucoma or ocular hypertension.
This was a randomized, multicenter, investigator-masked, 18-week study. At baseline after washout of intraocular pressure (IOP)-lowering medications, patients diagnosed with glaucoma or ocular hypertension began initial treatment with latanoprost for 6 weeks. At week 6, patients were randomized (stratified by baseline IOP and percent change from baseline IOP at week 6) to continue on latanoprost (n = 272) or switch to bimatoprost (n = 270) for 12 weeks. Outcome measures included IOP, biomicroscopy, and adverse events.
Baseline mean diurnal IOP was comparable in the 2 treatment groups. In the primary study endpoint, the reduction in mean diurnal IOP from baseline was statistically significantly greater in patients who switched to bimatoprost than in patients who remained on latanoprost at both week 12 (5.6 vs 4.9 mm Hg, P < .001) and week 18 (5.8 vs 5.1 mm Hg, P = .003). At week 18, patients switched to bimatoprost most commonly had a 2 mm Hg reduction in mean diurnal IOP from randomization (on latanoprost), while patients continued on latanoprost most commonly had no change in mean diurnal IOP. There were no significant between-group differences in the overall incidence of adverse events or the number of patients who discontinued due to adverse events after randomization, and no patients discontinued due to conjunctival hyperemia. While the incidence of conjunctival hyperemia was statistically significantly higher in the bimatoprost group (P = .050), a moderate or greater (≥ 2-grade) increase in the severity of conjunctival hyperemia from randomization was seen in only 3.3% of bimatoprost patients and 1.8% of latanoprost patients (P = .267).
After 6 weeks of initial latanoprost treatment, most patients who replaced latanoprost with bimatoprost achieved statistically significantly lower IOP without a clinically relevant increase in conjunctival hyperemia.
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