Document Detail

Intraocular pressure-lowering effect of adding dorzolamide or latanoprost to timolol: a meta-analysis of randomized clinical trials.
MedLine Citation:
PMID:  17070584     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To estimate the intraocular pressure (IOP)-lowering effect of 2% dorzolamide or 0.005% latanoprost when added to 0.5% timolol. DESIGN: Meta-analysis of randomized clinical trials. PARTICIPANTS: Seventeen articles reporting on 19 study arms with 5 possible treatment combinations and 4 study arms serving as controls. METHODS: Articles written in English, German, French, or Dutch and published up to December 2004 were identified in Medline, Embase, the Cochrane Controlled Trials Register, and references from relevant articles. For the article to be considered, over 85% of the patients had to have primary open-angle glaucoma or ocular hypertension. The pooled 1- to 3-month additional IOP-lowering effect after a run-in phase on timolol was calculated by performing meta-analysis using the random effects model. MAIN OUTCOME MEASURES: Absolute and relative changes in IOP after run-in on timolol for peak moment, trough moment, or mean diurnal curve. RESULTS: The pooled change from baseline [mean (95% confidence interval)] for 0.5% timolol varied from -0.7 mmHg (-1.2 to -0.2, for the mean diurnal curve) to -2.0 mmHg (-1.3 to -2.7, at peak). Pooled changes for 2% dorzolamide in concomitant use with 0.5% timolol were -4.1 mmHg (-4.4 to -3.8) at trough and -4.9 mmHg (-5.3 to -4.5) at peak. The fixed 2% dorzolamide and 0.5% timolol combination resulted in a pooled change of -3.8 mmHg (-4.2 to -3.4) at trough and -4.9 mmHg (-5.3 to -4.5) at peak. The concomitant use of 0.005% latanoprost and 0.5% timolol gave a pooled change from baseline of -6.0 mmHg (-6.8 to -5.2) at the mean diurnal curve. The fixed combination of 0.005% latanoprost and 0.5% timolol resulted in a mean change of -3.0 mmHg (-3.8 to -2.2) at the mean diurnal curve. CONCLUSION: In this meta-analysis of clinical trials, the addition of dorzolamide or latanoprost further lowers IOP in eyes on timolol. This result may not be generalizable because these trials may have included nonresponders to timolol.
Carroll A B Webers; Rikkert van der Valk; Jan S A G Schouten; Maurice P Zeegers; Martin H Prins; Fred Hendrikse
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't     Date:  2006-10-27
Journal Detail:
Title:  Ophthalmology     Volume:  114     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-02     Completed Date:  2007-01-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-6     Citation Subset:  IM    
Department of Ophthalmology, Maastricht University Hospital, Maastricht, The Netherlands.
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MeSH Terms
Antihypertensive Agents / therapeutic use*
Databases, Factual
Drug Therapy, Combination
Glaucoma, Open-Angle / drug therapy*
Intraocular Pressure / drug effects*
Prostaglandins F, Synthetic / therapeutic use*
Randomized Controlled Trials as Topic*
Sulfonamides / therapeutic use*
Thiophenes / therapeutic use*
Timolol / therapeutic use*
Reg. No./Substance:
0/Antihypertensive Agents; 0/Prostaglandins F, Synthetic; 0/Sulfonamides; 0/Thiophenes; 130209-82-4/latanoprost; 130693-82-2/dorzolamide; 26839-75-8/Timolol

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