Effectiveness and Safety of Dorzolamide – Timolol Alone or Combined with Latanoprost in Open-Angle Glaucoma or Ocular Hypertension

Lesk, Mark R.; Koulis, Theodoro; Sampalis, Fotini; Sampalis, John S.; Bastien, Natacha

doi:10.1345/aph.1k565

Cited by 20 publications

(12 citation statements)

References 22 publications

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“…We decided to use peak values (higher percentage POAG= primary open-angle glaucoma; FCTD= fixed combination of 0.5% timolol maleate/2% dorzolamide; NPDS= non penetrating deep sclerectomy of IOP reduction) for effectiveness. For the additive effect of FCTD over the prostaglandin analogue, only two studies were found in the literature and all of them evaluated the IOP reduction effect of FCTD added to latanoprost (20,21) . We assumed the same effect for the other two prostaglandin analogues (bimatoprost and travoprost).…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness comparison between non-penetrating deep sclerectomy and maximum-tolerated medical therapy for glaucoma within the Brazilian National Health System (SUS)

Guedes

Chaoubah

2012

Arq. Bras. Oftalmol.

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RESUMO Objetivo: A esclerectomia profunda não penetrante (EPNP) é uma opção viável para o tratamento cirúrgico do glaucoma de ângulo aberto. O objetivo deste estudo é avaliar a relação custo-efetividade da EPNP e compará-la com terapia clínica máxima (TCM) em ABSTRACTPurpose: Nonpenetrating deep sclerectomy (NPDS) has emerged as a viable option in the surgical management of openangle glaucoma. Our aim is to assess the cost eff ectiveness of NPDS and to compare it to maximum medical treatment in a 5year followup. Methods: A decision analysis model was built. Surgical (NPDS) arm of the decision tree was observational (consecutive retrospective case series) and maximum medical treatment arm was hypothetical. Maximum medical therapy was considered a three drug regimen (association of a fixed combination of timolol/dorzolamide [FCTD] and a prostaglandin analogue [bimatoprost, latanoprost or travoprost]). Costeffectiveness ratio was defined as direct cost (US dollars) for each percentage of intraocular pressure (IOP) reduction. Horizon was 5 years and perspective is from the public health care service in Brazil (SUS). Incremental costeffectiveness ratio (ICER) was calculated. Results: Direct cost for each percentage of IOP reduction in 5 years (costeffectiveness ratio) was US$ 10.19 for NPDS; US$ 37.45 for the association of a FCTD and bimatoprost; US$ 39.33 for FCTD and travoprost; and US$ 41.42 for FCTD and latanoprost. NPDS demonstrated a better costeffectiveness ratio, compared to maximum medical therapy. The ICER was negative for all medical treatment options; therefore NPDS was dominant. Conclusions: Despite some limitations, NPDS was both less costly and more effective than maximum medical therapy. From the Brazilian public health perspective, it was the most costeffective treatment option when compared to maximum medical the rapy (FCTD and prostaglandin).Keywords: Glaucoma/economy; Filtering surgery/economy; Health care costs; Cost eff ec tiveness evaluation Cost-effeCtiveness Comparison between non-penetrating deep sClereCtomy and maximum-tolerated mediCal therapy for glauComa within the brazilian national health system (sus)

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Section: Methodsmentioning

confidence: 99%

Cost-effectiveness comparison between non-penetrating deep sclerectomy and maximum-tolerated medical therapy for glaucoma within the Brazilian National Health System (SUS)

Guedes

Chaoubah

2012

Arq. Bras. Oftalmol.

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“…Both fixed dorzolamide/timolol and fixed brimonidine/timolol effectively reduce IOP when used alone7,8,11 or adjunctively with a prostaglandin analog,28,34 the most common first-line therapy 35. Further, both fixed dorzolamide/timolol7,8 and fixed brimonidine/timolol11 reduce IOP more effectively than monotherapy with their component medications.…”

Section: Efficacy and Safety Of Fixed Combinations Compared With Compmentioning

confidence: 99%

Considerations in glaucoma therapy: fixed combinations versus their component medications

Higginbotham

2009

OPTH

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Fixed combinations of medications that lower intraocular pressure (IOP) are increasingly used in the treatment of glaucoma and ocular hypertension and offer several potential advantages over combined use of the separate component medications including enhanced convenience, improved adherence, reduced exposure to preservatives, and possible cost savings. This review aims to examine the current role of IOP-lowering fixed combinations in disease management. The results of studies that compared the efficacy and safety of IOP-lowering fixed combinations with their component medications are summarized, including those fixed combinations that consist of a prostaglandin analog and timolol. The fixed combinations currently available for use in the United States are fixed-combination dorzolamide/timolol (FCDT) and fixed-combination brimonidine/timolol (FCBT). Both of these fixed combinations reduce IOP more effectively than their component medications used separately as monotherapy. FCBT therapy also demonstrates a more favorable safety profile and reduced ocular allergy compared to monotherapy with brimonidine, a component medication. Few studies have directly compared the efficacy and safety of FCDT and FCBT, but available evidence suggests that FCBT is at least as effective as FCDT in lowering IOP and is more comfortable and better tolerated. Additional studies are needed to further evaluate the comparative efficacy and tolerability of FCDT and FCBT in the management of glaucoma and ocular hypertension.

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“…Most clinical studies reported that triple non-fixed combination therapy of 2% dorzolamide, 0.5% timolol, and 0.002% latanoprost has a superior IOP lowering effect ( Akman et al, 2005 ; Lesk et al, 2008 ; Hatanaka et al, 2010 ; Konstas et al, 2017 ). Konstas AG, et al found that LTDz-nFC protects IOP from fluctuation and further more IOP reduction than latanoprost, DzT-FC, and LT-FC, with a mean 24 h-IOP of 22.1 mmHg, 19.9 mmHg, 19.5 mmHg, and 16.5 mmHg, and a IOP fluctuation of 4.7 mmHg, 4.4 mmHg, 4.1 mmHg, and 3.6 mmHg in latanoprost, DzT-FC, LT-FC, and LTDz-nFC-treated patients ( Konstas et al, 2017 ).…”

Section: Topical Non-fixed Combination Of Three Agentsmentioning

confidence: 99%

Topical Medication Therapy for Glaucoma and Ocular Hypertension

Wang

Cao²,

Jiang³

et al. 2021

Front. Pharmacol.

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Glaucoma is one of the most common causes of blindness, thus seriously affecting people’s health and quality of life. The topical medical therapy is as the first line treatment in the management of glaucoma since it is inexpensive, convenient, effective, and safe. This review summarizes and compares extensive clinical trials on the topical medications for the treatment of glaucoma, including topical monotherapy agents, topical fixed-combination agents, topical non-fixed combination agents, and their composition, mechanism of action, efficacy, and adverse effects, which will provide reference for optimal choice of clinical medication. Fixed-combination therapeutics offer greater efficacy, reliable security, clinical compliance, and tolerance than non-fixed combination agents and monotherapy agents, which will become a prefer option for the treatment of glaucoma. Meanwhile, we also discuss new trends in the field of new fixed combinations of medications, which may better control IOP and treat glaucoma.

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Effectiveness and Safety of Dorzolamide – Timolol Alone or Combined with Latanoprost in Open-Angle Glaucoma or Ocular Hypertension

Cited by 20 publications

References 22 publications

Cost-effectiveness comparison between non-penetrating deep sclerectomy and maximum-tolerated medical therapy for glaucoma within the Brazilian National Health System (SUS)

Cost-effectiveness comparison between non-penetrating deep sclerectomy and maximum-tolerated medical therapy for glaucoma within the Brazilian National Health System (SUS)

Considerations in glaucoma therapy: fixed combinations versus their component medications

Topical Medication Therapy for Glaucoma and Ocular Hypertension

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