Efficacy of single glaucoma drug in combined timolol XE, latanoprost and brinzolamide therapy: a discontinuation study.

Hiroshi Kobayashi

Index: J. Ocul. Pharmacol. Ther. 28(3) , 245-50, (2012)

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Abstract

To study the efficacy of a single drug in patients with primary open angle glaucoma and ocular hypertension who were receiving timolol XE 0.5%, latanoprost 0.005% and brinzolamide 1% with its discontinuation.Sixty patients with open-angle glaucoma or ocular hypertension who were administered timolol XE, latanoprost, and brinzolamide were studied. One drug consisting of timolol XE, brinzolamide, and latanoprost was discontinued and 8 weeks later, it was resumed. A change in intraocular pressure (IOP) was studied.Mean IOP at baseline and at 8 weeks after discontinuation of each drug was 15.8 ± 1.3 and 17.3 ± 1.4 mmHg in the timolol XE group, 15.8 ± 1.0 and 20.0 ± 1.4 mmHg in the latanoprost group, and 16.0 ± 1.4 and 18.1 ± 1.4 mmHg, respectively. A significant increase in mean IOP was found after drug discontinuation (timolol XE: P = 0.0012; latanoprost: P<0.0001; brinzolamide: P<0.0001). The mean change in IOP by discontinuation of the drug was +1.6 ± 0.9 mmHg (+9.6% ± 5.6%) in the timolol XE group, +4.3 ± 1.7 mmHg (27.4% ± 12.4%) in the latanoprost group, and +2.2 ± 0.9 mmHg (+13.7% ± 6.1%) in the brinzolamide group. The change in the latanoprost group was significantly greater compared with those in the timolol XE and brinzolamide groups (timolol XE: mmHg and percent: P<0.0001; brinzolamide: mmHg and percent: P<0.0001). The IOP change in the brinzolamide group was significantly greater than that in the timolol XE group (mmHg: P = 0.0417; percent: P = 0.0328). No significant difference was observed in mean IOP between before drug discontinuation and at 8 weeks after drug resumption in any group.There was a significant increase in IOP from discontinuation of timolol XE, latanoprost, and brinzolamide in the multiple drug treatment. The hypotensive effect of latanoprost in the combined drug therapy is significantly greater than the effects of timolol XE and brinzolamide.