Abstract
Aim
The aim of this study is to compare the 24-hour efficacy of dorzolamide/timolol-fixed combination (DTFC) and brimonidine/timolol-fixed combination (BTFC) in primary open-angle glaucoma (POAG).
Methods
One eye each of 77 POAG patients was included in this prospective, observer-masked, crossover comparison. Following a 2-month timolol run-in period, patients had three intraocular pressure (IOP) measurements at 1000, 1200 and 1400 h while on timolol treatment. Patients showing at least a 20% IOP reduction on timolol were randomised to 3 months of therapy with DTFC or BTFC, and then were crossed over to the opposite therapy.
Results
Sixty POAG patients completed the study. The mean 24-hour IOP was significantly reduced with both the fixed combinations compared with the timolol-treated diurnal IOP (P<0.001). When the two fixed combinations were compared directly, DTFC demonstrated a lower mean 24-hour IOP level as compared with BTFC (mean difference: −0.7 mm Hg, 95% confidence interval (CI): (−1.0, −0.3), P<0.001). At two individual time points, DTFC significantly reduced IOP more than BTFC: at 1800 h (−1.0 mm Hg, 95% CI (−1.6,−0.5), P=0.001) and at 0200 (−0.9 mm Hg, 95% CI: (−1.4,−0.5), P=0.001). No significant difference existed for the other time points.
Conclusion
Both the fixed combinations significantly reduce 24-hour IOP in POAG. DTFC provided significantly better 24-hour efficacy.
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Competing interests
Dr Konstas is a consultant and has received research funding from Alcon, Allergan, MSD, and Pfizer. Dr Quaranta is a consultant at Alcon and MSD. Dr Yan is a consultant at Alcon, Allergan, and MSD. Dr Mikropoulos is a consultant at Alcon and Allergan. Dr Riva is a consultant at Allergan and MSD. Mr Barton is a consultant at Alcon, Aquesys, and MSD. Drs Gill and Haidich declare no conflict of interest. This study was not supported by any public or private body.
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Ethical approval
The research protocol was approved by the Bioethics Committee of the Medical School of the Aristotle University of Thessaloniki and the study was registered at ClinicalTrials.gov (identifier NCT00972257). The study procedures were in accordance with the ethical standards of the Helsinki Declaration of 1975 (as revised in 1983).
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Konstas, A., Quaranta, L., Yan, D. et al. Twenty-four hour efficacy with the dorzolamide/timolol-fixed combination compared with the brimonidine/timolol-fixed combination in primary open-angle glaucoma. Eye 26, 80–87 (2012). https://doi.org/10.1038/eye.2011.239
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DOI: https://doi.org/10.1038/eye.2011.239
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