Comparative Efficacy of Travoprost vs Latanoprost in Lowering Intraocular Pressure in African Americans

Abstract

Abstract: : PURPOSE: Previous literature has reported that travoprost is more effective than latanoprost in lowering intraocular pressure in African Americans. However, these findings have not been universally applied to clinical practice. This study was designed to validate the superiority of travoprost over latanoprost in the African American population with open angle glaucoma or ocular hypertension. METHODS: African American patients with open angle glaucoma or ocular hypertension on latanoprost for at least six months were recruited for this blinded, prospective, randomized clinical trial. At the baseline visit, patients were given a new open label bottle of latanoprost to use daily for one month. At one month (Day 0), patients returned for IOP measurements and were randomized to receive a masked bottle of either travoprost (0.004%) or latanoprost (0.005%). Follow–up visits were conducted at 2 weeks to assess safety and at 3 months for a final re–examination. The IOP measurements were taken twice each visit separated by one hour. To control for diurnal variation, measurements were obtained in the same half–day period. Hyperemia was graded by a blinded examiner as none, mild, moderate or severe based on external photographs taken at Day 0 and 3 months. RESULTS: Fifty–six patients were recruited and completed the study. The mean differences in IOP for travoprost and latanoprost were 0.065 and 0.76 respectively. A two sample t–test showed no statistically significant difference between the two treatments in the average changes in IOP over time, regardless of measurements used (p = 0.25–0.52). Only six patients developed mild hyperemia. Five of the six were in the travoprost treatment group. No patients had subjective increase in hyperemia. CONCLUSIONS: In a masked, prospective, randomized clinical trial, travoprost compared to latanoprost failed to demonstrate a superiority in lowering IOP in African American patients with open angle glaucoma or ocular hypertension.

Keywords: intraocular pressure • drug toxicity/drug effects • pharmacology