A 3-month clinical trial comparing the IOP-lowering efficacy of bimatoprost and latanoprost in patients with normal-tension glaucoma

Abstract

This multicenter, randomized, double-blind clinical trial was undertaken to compare the intraocular pressure (IOP)-lowering efficacy and safety of topical bimatoprost 0.03% with that of latanoprost 0.005% for the treatment of patients with normal-tension glaucoma. After washout of all ocular hypotensive medications, patients with normal-tension glaucoma (n=60) were randomly assigned to oncedaily bimatoprost 0.03% or latanoprost 0.005% for 3 mo. Diurnal IOP measurements were taken at each study visit. Primary outcome measures consisted of mean change from baseline IOP (8 AM, Noon, 4 PM) and change in visual field. Secondary measures included mean IOP, ophthalmologic examination findings, results of clinical evaluation, and adverse events. Mean change from baseline IOP at each study visit was statistically significant at all diurnal measurements for patients taking bimatoprost and for those taking latanoprost (P<.001). The 8 AM mean change from baseline IOP measurement showed a significant between-group difference (P< or =.033) in favor of bimatoprost at both follow-up visits. After 3 mo of treatment, mean IOP reductions from baseline ranged from 2.8 to 3.8 mm Hg (17.5%-21.6%) with bimatoprost and from 2.1 to 2.6 mm Hg (12.7%-16.2%) with latanoprost. Overall mean reduction in IOP after 3 mo of treatment was 3.4 mm Hg (19.9% rpar; with bimatoprost and 2.3 mm Hg (14.6%) with latanoprost (P=.035). No significant between-group differences were observed in incidence of adverse events, clinical success, or demographic variables. Bimatoprost was found to be more effective than latanoprost in lowering IOP in the patient with normal-tension glaucoma. Both drugs were efficacious and well tolerated.

Effect of travoprost on 24-hour intraocular pressure in normal tension glaucoma

“…18 Achievement of an IOP reduction greater than 30% as recommended by the CNTG study group is very difficult using a single, topical antiglaucoma eye drop. [10][11][12][13]17,18,20,21 In our study, the rates of 30% IOP reduction are 23.5% for maximum 24-hour IOP and 11.8% for mean 24-hour IOP. When a topical combination therapy is needed to achieve the target reduction in IOP, travoprost without BAK is a superior option because preservatives such as BAK can induce conjunctival inflammation and affect success rates for filtering surgery.…”

“…In previous studies, IOP reduction by latanoprost 0.005% and bimatoprost 0.03% in NTG has been reported to be in the range of 12.7% to 20% and 16% to 21.6%, respectively. 10,13,20,21 Travoprost 0.004% has been reported to have similar results (16.7% to 25.1%). 17,18 Our results are in accordance with the results of these previous studies.…”

“…9,10 Latanoprost 0.005% and bimatoprost 0.03%, both prostaglandin analogs, are effective in reducing IOP in NTG patients. [10][11][12][13] Another prostaglandin analog, travoprost 0.004%, has been shown to be equivalent in the reduction of IOP in primary open angle glaucoma and ocular hypertension. 9,[14][15][16] However, only two reports have investigated the effect of travoprost on NTG.…”

Clinical utility and differential effects of prostaglandin analogs in the management of raised intraocular pressure and ocular hypertension

“…Ten of the 15 trials involved a PGA. 44,53,56,103,114,169,[170][171][172][173] Subjects (n = 1571) switched to latanoprost from previous glaucoma monotherapy and fixed and unfixed combination therapies maintained IOP to an acceptable level through a 2-year period. 174 Latanoprost-insensitive patients developed IOP lowering with bimatoprost in a randomized prospective study with two 30-day treatment phase and 30-day washout phase.…”

“…Bimatoprost was superior in IOP lowering to travoprost only during the daytime (0800 and 1200 hours time-points), but latanoprost and travoprost were comparable at all time points (P # 0.82). 88 An industry-sponsored meta-analysis 90 of travoprost vs latanoprost (15 trials, n = 1098), 57,68,85,93,95,96,[98][99][100] travoprost vs bimatoprost (8 trials, n = 714), 57,85,87,93,95,96,101,102 and latanoprost vs bimatoprost (8 trials, n = 943) 57,64,85,86,93,95,96,103 found similar efficacy among the three PGAs. Studies comparing the PGA to other non-PGA glaucoma treatments, nonrandomized, dose-finding or cross-over trials, and short-term evaluations (less than 3 months) were excluded, although a trial evaluating timolol plus travoprost versus timolol alone, 100 was included indicating that the PGA effect has the same relative effect as if it were compared with no treatment.…”