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Dual therapy improves glaucoma management

By Lilian Anekwe

A fixed combination of bimatoprost and a beta-blocker is most effective at lowering intra-ocular pressure (IOP) in patients with open-angle glaucoma, a double-blind randomised controlled trial comparing different prostaglandin analogues shows.

Researchers gave 89 patients with an IOP of less than 21 mm Hg a six-week run-in period with latanoprost 50 mcg plus timolol 5 mg/ml, the randomised them to either travoprost plus timolol or bimatoprost plus timolol for three months, before switching to the opposite therapy for an additional three months.

At baseline, mean IOP was 16.5 mm Hg after treatment with latanoprost plus timolol. But a prospective analysis of mean daily IOP after three months of each treatment showed tha mean IOP was significantly lower in the bimatoprost plus timolol group, at 14.7 mm Hg, compared with the travoprost plus timolol group, at 15.4 mm Hg. Both treatments showed a similar tolerability profile.

Lead researcher Dr Marco Centofanti, an ophthalmologist at the University of Tor Vergata in Rome, concluded: ‘The results of this randomised clinical trial showed that both travoprost plus timolol and bimatoprost plus timolol provide further IOP reduction in glaucoma patients previously treated with latanoprost plus timolol.

‘Mean daily IOP after three months of treatment was statistically significantly lower during bimatoprost plus timolol treatment than during travoprost plus timolol treatment.'

Am J Ophthalmol 2010; 150: 575-580

A bimatoprost and timolol combination significantly reduced intra-ocualr pressure

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