Fixed topical combinations in glaucomatous patients and ocular discomfort

Nebbioso, Marcella; Evangelista, Mariasilvia; Librando, Aloisa; Blasio, Dario Di; Pescosolido, Nicola

doi:10.1517/14656566.2012.705830

Cited by 9 publications

(11 citation statements)

References 36 publications

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“…In a prospective, randomized study evaluating differences in ocular discomfort between two fixed combinations containing the preservative benzalkonium chloride, the fixed combination containing dorzolamide and timolol was associated with greater ocular discomfort than the fixed combination of brinzolamide and timolol. 33 …”

Section: Ocular Tolerability Of Carbonic Anhydrase Inhibitors In Combmentioning

confidence: 99%

The impact of timolol maleate on the ocular tolerability of fixed-combination glaucoma therapies

Radcliffe

2014

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Glaucomatous optic atrophy is the second most common cause of blindness worldwide, and lowering intraocular pressure (IOP) is the only proven method to slow or stop the progression of the disease. Approximately 40% of patients with elevated IOP will require more than one medication to obtain a modest 20% reduction in IOP, and as a result, some patients may require two medications, provided in either two separate bottles or in one bottle with the use of fixed-combination therapies. Each therapy has its own unique safety and efficacy profile. Topical beta-blockers have a particularly favorable ocular-tolerability profile, and several studies of fixed-combination medications containing the beta-blocker timolol maleate have shown a lower prevalence of some ocular adverse events for the fixed-combination therapy compared to the non-beta-blocker individual component. In this review, we examined clinical data pertaining to the ocular surface tolerability of fixed-combination medications containing timolol maleate in comparison to the individual components. In particular, preference was given to prospective, randomized, multicenter trials of 3 months in duration or longer that compared a fixed-combination therapy to monotherapy with the individual components. A review of the literature revealed that some fixed-combination therapies can provide a reduced risk of common side effects compared to their individual components, with conjunctival hyperemia and ocular allergy being less frequent in some timolol-containing fixed-combination therapies. This effect appears to be most significant for latanoprost 0.005%, bimatoprost 0.03%, and brimonidine 0.2%.

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Section: Ocular Tolerability Of Carbonic Anhydrase Inhibitors In Combmentioning

confidence: 99%

The impact of timolol maleate on the ocular tolerability of fixed-combination glaucoma therapies

Radcliffe

2014

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“…BRINTFC was recently compared to DTFC. Mostly 1% brinzolamide-0.5% timolol ophthalmic suspension is associated with a statistically significantly less ocular discomfort profile than 2% dorzolamide-0.5% timolol ophthalmic solution [19][20][21][22]. BIMATOFC was compared to 0.03% bimatoprost [23].…”

Section: Introductionmentioning

confidence: 99%

Comparative Evaluation of the Efficacy of the Bimatoprost 0.03%, Brimonidine 0.2%, Brinzolamide 1%, Dorzolamide 2%, and Travoprost 0.004%/Timolol 0.5%-Fixed Combinations in Patients Affected by Open-Angle Glaucoma

Giuffrè¹

2012

OJOph

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Purpose: This is a retrospective, comparative, head-to-head, not commissioned study about the efficacy of bimatoprost 0.03%, brimonidine 0.2%, brinzolamide 1%, dorzolamide 2%, and travoprost 0.004%/timolol 0.5%-fixed combinations in patients affected by naΐve open-angle glaucoma and IOP > 25 mmHg. Patients and Methods: Files from 70 patients (35 M, 35 F, mean age 69.52 y, S.D. 11.56, range: 37-87 y) in our Glaucoma Service were retrospectively analyzed as long as 12 months. Every subgroup, including 14 age-and sex-matched patients, was allocated to 1 of the 5 groups of the fixed combinations monotherapy. Data recorded after 3 months follow-up were statistically analyzed by descriptive and ANOVA statistics as percentage of IOP reduction from baseline. Results: All the fixed combinations were effective in lowering IOP. The mean percentage reduction was: brimonidine/timolol 43.57%, dorzolamide/timolol 37.67%, bimatoprost/timolol 35.60%, travoprost/timolol 33.25% and brinzolamide/timolol 23.0%. The brimonidine/timolol fixed combination showed to be statistically significant more effective only than brinzolamide/timolol fixed combination (p = 0.001). Setting the α error to 5%, the power of the study is 26%, phi: 0.842. Discussion: In all this cohort of patients the target IOP was successfully achieved. All the fixed combinations used in this study had a very good profile of efficacy. Brimonidine, dorzolamide, bimatoprost and travoprost/timolol fixed combinations statistically significantly reduced the percentage of IOP from baseline (p = 0.001) more than brinzolamide/timolol fixed combination.

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“…Nebbioso et al compared Ocular Surface Disease Index scores between a group receiving brinzolamide 1%/timolol 0.5% and a group receiving dorzolamide 2%/timolol 0.5%. 21 They reported that the score was significantly lower in the brinzolamide 1%/timolol 0.5% group, and showed that brinzolamide 1%/timolol 0.5% was better tolerated than dorzolamide 2%/timolol 0.5%. 21 …”

Section: Discussionmentioning

confidence: 98%

“…Applying a combination of anti-glaucoma eye drops can cause corneal damage 19 due to the effects of preservatives and substrates. 19 , 21 – 24 Switching from an eye drop with preservatives to one without preservatives among beta-blockers has been shown to result in a statistically significant improvement for break-up time and Schirmer’s test, as well as patient feelings of dryness and foreign body sensations. 23 …”

Section: Discussionmentioning

confidence: 99%

Efficiency, safety, and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog

Shimizu¹,

Nakakura²,

Nishiyama³

et al. 2015

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BackgroundWe investigated the efficiency, safety and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog.MethodsWe initially enrolled 44 eyes from 44 primary open angle glaucoma patients, and a total of 42 patients completed the study. All patients were under treatment with various prostaglandin F2α analogs and dorzolamide 1%/timolol 0.5%. While maintaining the prostaglandin F2α analog, dorzolamide 1%/timolol 0.5% was switched to brinzolamide 1%/timolol 0.5%. Conjunctival hyperemia, superficial punctate keratopathy, and intraocular pressure (IOP) were evaluated at baseline and at 4, 12, and 24 weeks. Adverse events and patient preferences, measured using a questionnaire at study initiation and at 24 weeks, were also noted.ResultsThe IOP was 17.7±1.7, 16.8±2.6, 16.7±2.2, and 16.7±2.4 mmHg at baseline and at 4, 12, and 24 weeks, respectively, with no significant differences in IOP values at any time point (P=0.117, one-way analysis of variance). In addition, no significant differences were found in the incidence of conjunctival hyperemia or SPK score at any time point (all P>0.5, by Kruskal–Wallis test). Based on the evaluation of side effects using the questionnaire, stinging/burning was less common (P=0.042), while blurred vision was more common (P=0.003), after switching to brinzolamide 1%/timolol 0.5%. Regarding patient preferences, 13 patients (31%) preferred dorzolamide 1%/timolol 0.5%, 12 patients (29%) preferred brinzolamide 1%/timolol 0.5%, and 17 patients (40%) preferred neither.ConclusionWhen switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5%, the IOP values and incidence of superficial punctate keratopathy and conjunctival hyperemia were sustained throughout the 24-week observation period, and the patient preferences were similar for the two regimens. However, differences were observed in the ocular sensations of stinging/burning with dorzolamide 1%/timolol 0.5% and blurred vision with brinzolamide 1%/timolol 0.5%.

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Fixed topical combinations in glaucomatous patients and ocular discomfort

Cited by 9 publications

References 36 publications

The impact of timolol maleate on the ocular tolerability of fixed-combination glaucoma therapies

The impact of timolol maleate on the ocular tolerability of fixed-combination glaucoma therapies

Comparative Evaluation of the Efficacy of the Bimatoprost 0.03%, Brimonidine 0.2%, Brinzolamide 1%, Dorzolamide 2%, and Travoprost 0.004%/Timolol 0.5%-Fixed Combinations in Patients Affected by Open-Angle Glaucoma

Efficiency, safety, and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog

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Fixed topical combinations in glaucomatous patients and ocular discomfort

Cited by 9 publications

References 36 publications

The impact of timolol maleate on the ocular tolerability of fixed-combination glaucoma therapies

The impact of timolol maleate on the ocular tolerability of fixed-combination glaucoma therapies

Comparative Evaluation of the Efficacy of the Bimatoprost 0.03%, Brimonidine 0.2%, Brinzolamide 1%, Dorzolamide 2%, and Travoprost 0.004%/Timolol 0.5%-Fixed Combinations in Patients Affected by Open-Angle Glaucoma

Efficiency, safety, and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2&alpha; analog

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Efficiency, safety, and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog