Abstract
Purpose: :
To evaluate the diurnal IOP control and safety of bimatoprost versus latanoprost in patients with exfoliative glaucoma (XFG).
Methods: :
One eye of 130 consecutive XFG patients (mean age: 66.5±8.3 year) was included in this prospective, observer–masked, crossover comparison. After a 4–6 week medicine–free period patients were randomized to either bimatoprost or latanoprost, both dosed once each evening, alone for 3 months. Patients were then switched to the opposite therapy for 3 months. At the end of the washout and treatment periods IOP was measured at 8.00 a.m., 13.00 p.m. and 18.00 p.m.
Results: :
At baseline IOP (mean±SD) was 28.0±4.0 mmHg, 26.9±3.6 mmHg and 25.9±3.6 mmHg, at the 3 timepoints measured. Both treatments significantly reduced mean diurnal IOP at 3 months. Mean diurnal IOP was 26.9±3.5 mmHg at baseline, 17.6±3.3 mmHg with bimatoprost and 18.6±3.6 mmHg with latanoprost (p<0.0001). Bimatoprost obtained lower IOP values at all timepoints (17.9±3.4 mmHg, 17.3±3.3 mmHg and 17.6±3.5 mmHg, respectively) in comparison with latanoprost (18.7±3.6 mmHg, 18.5±3.6 mmHg and 18.6±4.1 mmHg). The corresponding mean differences (0.8 mmHg, 1.1 mmHg and 1.0 mmHg, respectively) were all significant (p<0.001 for each comparison). Significantly more patients obtained a target diurnal IOP<17 mmHg on bimatoprost than latanoprost (55 vs 34; p=0.003). More patients reported at least one adverse event on bimatoprost than latanoprost (58 vs. 41 at 3 months; p=0.0003) and the number of the adverse events was independent from treatment order (p=0.46).
Conclusions: :
This crossover study suggests that in XFG bimatoprost obtains better diurnal IOP control than latanoprost.
Keywords: intraocular pressure • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • drug toxicity/drug effects