Objective To evaluate the intraocular pressure (IOP)-lowering effects of all common glaucoma drugs when added to 0.005% latanoprost once a day.
Methods Pertinent publications were identified through systematic searches of PubMed, EMBASE, and the Cochrane Controlled Trials Register. Randomized clinical trials involving over 85% patients with primary open angle glaucoma or ocular hypertension who treated with the combination treatment of latanoprost were selected. The pooled additional IOP-lowering effects at 1 to 3 months after a run-in phase of at least 2 weeks on 0.005% latanoprost once daily were calculated using two-step DerSimonian and Laird estimate method of the random effects model.
Results Thirteen randomized clinical trials were included in the meta-analysis. The pooled IOP reduction from baseline [mean (95% confidence interval)] were 3.3 mmHg (2.1 to 4.5) at trough and 4.4 mmHg (3.4 to 5.4) at peak when adding 0.5% timolol once daily; 2.6 mmHg (1.6 to 3.7) at diurnal curve to 3.8 mmHg (2.5 to 5.2) at peak when adding 0.1%/0.15% brimonidine twice daily; 2.6 mmHg (1.7 to 3.4) at trough to 3.1 mmHg (2.6 to 3.6) at peak when adding 2% dorzolamide twice daily; 2.3 mmHg (1.9 to 2.7) at diurnal curve to 2.7 mmHg (2.2 to 3.2) at peak when adding 0.5% timolol twice daily; 2.1 mmHg (1.3 to 2.9) at diurnal curve to 1.8 mmHg (1.2 to 2.3) at peak when adding 1% brinzolamide twice daily; 1.3 mmHg (0.8 to 1.8) at peak when adding 2% carteolol twice daily; 1.2 mmHg (0.2 to 2.2) at peak when adding 0.01% bunazosin twice daily; 1.0 mmHg (0.4 to 1.6) at peak when adding 1% dorzolamide thrice daily; 0.8 mmHg (-0.1 to 1.6) at peak when adding 0.25% nipradilol twice daily; 0.3 mmHg (-0.7 to 1.4) at peak to 1.1 mmHg (0.3 to 1.9) at diurnal curve when adding 0.12% unoprostone twice daily; -1.9 mmHg (-3.6 to -0.2) at peak when adding 0.03% bimatoprost once daily.
Conclusions Adding brimonidine, dorzolamide, timolol, or brinzolamide to latanoprost can lead to a greater additional decrease in IOP in patients with primary open angle glaucoma and ocular hypertension. The differences in additional IOP-lowering effects among these glaucoma drugs are small. |
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