S 473
A comparison of the efficacy and safety of latanoprost with brimonidine in patients with open angle glaucoma and ocular hypertension
A. Kampik and the Latanoprost Study Group
Purpose: To compare the intraocular pressure (IOP) lowering effect and safety of latanoprost 0.005 % once daily with brimonidine 0.2 % twice daily in patients with open angle glaucoma and ocular hypertension.
Methods: In this prospective, multinational, randomized study, 379 patients currently on monotherapy or dual therapy were recruited. After an appropriate wash-out period, patients were randomized to receive either latanoprost once daily, in the evening, or brimonidine twice daily for 3 months. The morning IOP (10 a.m.) was recorded 12 hours after the dose of latanoprost and 2 hours after the dose of brimonidine while the afternoon (5 p.m.) measurements were recorded 19 hours after latanoprost and 9 hours after brimonidine.
Results: From an overall baseline of 24.9 mmHg the mean IOP reduction was 7.5 mmHg (30%) in latanoprost treated patients and 5.8 mmHg (23 %) in brimonidine treated patients. The proportion of patients who had an IOP reduction of greater than 30% from baseline to month 3 was 49 % (10 a.m.) and 47 % (5 p.m.) in the latanoprost group compared with 31 % (10 a.m.) and 25 % (5 p.m.) in the brimonidine group. The proportions of patients with an IOP reduction of less than 15 % from baseline to month 3 was 8 % (10 a.m.) and 11 % (5 p.m.) in the latanoprost group compared with 25 % (10 a.m.) and 33 % (5 p.m.) in the brimonidine group. Systemic adverse events were more frequently reported in the brimonidine group (39/94) than in the latanoprost group (16/54). There were 7 patients in the brimonidine group and 2 patients in the latanoprost group who were withdrawn due to uncontrolled IOP. The results of the 6 month observation as far as available will be discussed.
Conclusion: Latanoprost once daily was more effective (-1.7 mmHg, p< 0.001; ANCOVA) than brimonidine twice daily in reducing mean IOP after 3 months of treatment.
Ludwig-Maximilians-Universität, Augenklinik, Klinikum Innenstadt, Mathildenstraße 8, D-80336 München