“…Previous meta‐analyses have compared the IOP lowering efficacy of drugs such as latanoprost and timolol, among others (Denis et al. 2007; Stewart et al. 2008), but these comparisons have been carried out between only a limited number of regimens because data from randomized controlled trials involve limited types of drugs.…”
PurposeTo assess the efficacy and safety of different regimens, including monotherapy and double therapy, for primary open‐angle glaucoma (POAG) or ocular hypertension.MethodsWe searched PubMed, EMBASE and clinicaltrials.gov for studies that fit our inclusion criteria in this network meta‐analysis. Randomized controlled trials that report data on efficacy and safety of medications for POAG or ocular hypertension are included. Data on intra‐ocular pressure (IOP) lowering effect and incidence of adverse events including hyperaemia and ocular discomfort were extracted and used in mixed‐comparison analysis.ResultsThis study includes 72 randomized trials. Data were available on 12 medical treatments of POAG or ocular hypertension. Of 66 possible comparisons of outcome efficacy, 15 treatments were compared directly. Compared to prostaglandin analogues (PGA), beta‐blockers (BB) showed relatively weaker ability to lower IOP, followed by α2‐adrenergic agonists (AA) and carbonic anhydrase inhibitors (CAI). For dual therapy, regimens composed of a combination of PGA with another treatment demonstrated more powerful IOP lowering efficacy, while the combination of two non‐PGA drugs had lower efficacy in controlling IOP than PGA alone. There was no statistical significance in combinations that did not include PGA on efficacy of IOP control. In terms of tolerance, PGA alone leads to more severe hyperaemia than any other monotherapy regimen, while BBs have the lowest effect on the incidence of hyperaemia. Most dual therapy regimens containing PGA also lead to serious hyperaemia, with the exception of PGA + AA. Compared to regimens containing PGA, those with BB are less likely to cause hyperaemia.ConclusionOur network meta‐analysis showed that PGAs provide best IOP lowering effect among all the monotherapy regimen. Combination of PGA and other category of drugs leads to better IOP decrease. Combination of BB and another non‐PGA drug may have less ocular side‐effects than PGA alone.
“…Previous meta‐analyses have compared the IOP lowering efficacy of drugs such as latanoprost and timolol, among others (Denis et al. 2007; Stewart et al. 2008), but these comparisons have been carried out between only a limited number of regimens because data from randomized controlled trials involve limited types of drugs.…”
PurposeTo assess the efficacy and safety of different regimens, including monotherapy and double therapy, for primary open‐angle glaucoma (POAG) or ocular hypertension.MethodsWe searched PubMed, EMBASE and clinicaltrials.gov for studies that fit our inclusion criteria in this network meta‐analysis. Randomized controlled trials that report data on efficacy and safety of medications for POAG or ocular hypertension are included. Data on intra‐ocular pressure (IOP) lowering effect and incidence of adverse events including hyperaemia and ocular discomfort were extracted and used in mixed‐comparison analysis.ResultsThis study includes 72 randomized trials. Data were available on 12 medical treatments of POAG or ocular hypertension. Of 66 possible comparisons of outcome efficacy, 15 treatments were compared directly. Compared to prostaglandin analogues (PGA), beta‐blockers (BB) showed relatively weaker ability to lower IOP, followed by α2‐adrenergic agonists (AA) and carbonic anhydrase inhibitors (CAI). For dual therapy, regimens composed of a combination of PGA with another treatment demonstrated more powerful IOP lowering efficacy, while the combination of two non‐PGA drugs had lower efficacy in controlling IOP than PGA alone. There was no statistical significance in combinations that did not include PGA on efficacy of IOP control. In terms of tolerance, PGA alone leads to more severe hyperaemia than any other monotherapy regimen, while BBs have the lowest effect on the incidence of hyperaemia. Most dual therapy regimens containing PGA also lead to serious hyperaemia, with the exception of PGA + AA. Compared to regimens containing PGA, those with BB are less likely to cause hyperaemia.ConclusionOur network meta‐analysis showed that PGAs provide best IOP lowering effect among all the monotherapy regimen. Combination of PGA and other category of drugs leads to better IOP decrease. Combination of BB and another non‐PGA drug may have less ocular side‐effects than PGA alone.
“…In [7], it draws a conclusion as Patients treated with travoprost and bimatoprost had lower IOP levels at the end of follow-up than those treated with latanoprost. Thus we have the 4th QC base Q 4 = {tr > la, bi > la}.…”
Section: Case Studymentioning
confidence: 94%
“…Trial results are a summary of the underlying statistical analysis, usually there is a qualitative statement comparing two drugs of interest. For example, in [1,5,6,7,12,14], comparisons of different drugs on the efficacy of lowering intraocular pressure (called IOP reduction) are experimented. The comparisons of drugs on IOP reduction are often expressed in the form of e.g.…”
The number of clinical trials reports is increasing rapidly due to a large number of clinical trials being conducted, it therefore raises an urgent need to utilize the clinical knowledge contained in the clinical trials reports. In this paper, we focus on the qualitative knowledge instead of quantitative knowledge. More precisely, we aim to model and reason with the qualitative comparison (QC for short) relations which consider qualitatively how strongly one drug/therapy is preferred to another in a clinical point of view. To this end, first, we formalize the QC relations, introduce the notions of QC language, QC base, and QC profile; second, we propose a set of induction rules for the QC relations, and provide grading interpretations for the QC bases and show how to determine whether a QC base is consistent. Furthermore, when a QC base is inconsistent, we analyze how to measure inconsistencies among QC bases, and we propose different approaches to merging multiple QC bases. Finally, a case study on lowering intraocular pressure is conducted to illustrate our approaches.
“…These findings are similar to those reported in the present literature. Parrish et al In a recent metaanalysis including nine studies, travoprost and bimatoprost were declared to be more effective to reduce IOP than latanoprost (Denis et al, 2007). Stinging/burning, itching, conjunctival hyperemia, hypertrichosis, eyelid erythema, pigmentation in the iris and periocular skin, cystoid macular edema in pseudophakic and aphakic patients, recurrence of uveitis and herpes simplex keratitis, coroidal detachment and hypotonia have been reported during treatment with prostaglandin analogs (Hylton and Robin, 2003;Turaçlı, 2003).…”
The aim of this study was to compare the efficacy and safety of latanoprost, travoprost and bimatoprost monotherapies in previously untreated patients with open angle glaucoma and ocular hypertension. This study included thirty-six eyes of 18 patients diagnosed with primary open angle glaucoma (POAG) and ocular hypertension (OHT) at Ondokuz Mayıs University, Medical Faculty, Department of Ophthalmology. All patients were underwent complete ophthalmic examination. Patients were randomized into 3 groups with six patients; group 1 received latanoprost 0.005% (Xalatan, Pharmacia), group 2 received travoprost 0.004% (Travatan, Alcon) and group 3 received bimatoprost 0.03% (Lumigan, Allergan) monotherapies. First examination was performed at the beginning of the study. Control examinations were performed at the 2, 4, 12 and 24th weeks of the therapy. Efficacy and side effects of these drugs were evaluated on each control visits. There were no significant differences in demographic characteristics among treatment groups. Baseline mean intra ocular pressure (IOP) levels were 26.50±3.14 mmHg in group 1, 25.58±3.62 mmHg in group 2 and 24.66±3.62 mmHg in group 3. Mean IOP levels were similar at end of the study between groups and 14.83±2.24 mmHg in group 1, 16.41±4.16 mmHg in group 2 and 16.16±3.53 mmHg in group 3. The most frequent side-effect was conjunctival hyperemia, which was determined in none of the patients in group 1, in 2 eyes in group 2 (16.7%) and 6 eyes in group 3 (50%). There was no statistically significant difference of IOP between latanoprost, travoprost and bimatoprost monotherapies. The side-effects were fewest in the latanoprost group and the most frequent in the bimatoprost group.
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