Document Detail

Mixed treatment comparison and meta-regression of the efficacy and safety of prostaglandin analogues and comparators for primary open-angle glaucoma and ocular hypertension.
MedLine Citation:
PMID:  20014995     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Primary open-angle glaucoma (POAG) is a chronic condition characterised by optic neuropathy and vision loss. Elevated intraocular pressure (IOP) can damage the optic nerve and is a risk factor for glaucoma, thus treatment usually comprises topical hypotensives. This analysis aims to address methodological issues associated with the synthesis of glaucoma clinical trial data, given variations in study methodology and IOP measurement. METHODS: Meta-regression was used to estimate how IOP varies over time for patients receiving treatment. Relative treatment effects were assessed using a random-effects mixed treatment comparison (MTC) in order to preserve randomisation and avoid selection bias. To produce clinically meaningful outputs, these analyses were combined to obtain the mean on-treatment IOP and the proportion of patients achieving different IOP targets at different time points. A further MTC estimated the probability of hyperaemia events. RESULTS: The analysis showed that after 3 months' treatment, between 58 and 83% of patients will have a > or =20% reduction in IOP and 70-93% of patients will have an absolute IOP <20 mmHg. Latanoprost and bimatoprost were found to produce significantly lower on-treatment IOP compared with timolol (p < 0.05); the difference between latanoprost and bimatoprost was not significant. Travoprost produced a lower mean IOP compared with timolol (not significant). Latanoprost-timolol was found to produce significantly lower IOP than latanoprost alone or beta-blockers. The probability of hyperaemia-type events varied between treatments from 14.8 to 63.03%. Latanoprost had significantly lower odds of hyperaemia than travoprost, bimatoprost, travoprost-timolol, or bimatoprost-timolol. CONCLUSION: This analysis suggests that latanoprost and bimatoprost produce a statistically significant reduction in IOP compared with timolol, but are associated with a higher risk of hyperaemia. Out of all the prostaglandins, latanoprost may achieve a good balance between tolerability and IOP efficacy. As with all forms of meta-analysis, the results are based on the assumption that the studies and intervention groupings are sufficiently similar to be compared.
M Orme; S Collins; H Dakin; S Kelly; J Loftus
Related Documents :
18001245 - Long-term intraocular pressure fluctuation and visual field progression in glaucoma pat...
3765185 - Therapeutic ultrasound.
22964885 - Minimally invasive lateral lumbar interbody fusion: clinical and radiographic outcome a...
12750105 - Subconjunctival mitomycin c as adjunctive therapy before pterygium excision.
19699335 - Effect of two-day atorvastatin pretreatment on the incidence of periprocedural myocardi...
3488385 - Early treatment with erythromycin of campylobacter jejuni-associated dysentery in child...
Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current medical research and opinion     Volume:  26     ISSN:  1473-4877     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-05-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  England    
Other Details:
Languages:  eng     Pagination:  511-28     Citation Subset:  IM    
Abacus International, Bicester, Oxfordshire, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Antihypertensive Agents / administration & dosage*,  adverse effects
Glaucoma, Open-Angle / drug therapy*
Ocular Hypertension / drug therapy*
Prostaglandins F, Synthetic / administration & dosage*,  adverse effects
Randomized Controlled Trials as Topic
Time Factors
Reg. No./Substance:
0/Antihypertensive Agents; 0/Prostaglandins F, Synthetic

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Cost-effectiveness analysis of the use of a high-intensity statin compared to a low-intensity statin...
Next Document:  In vitro Reconstruction of an Autologous, Watertight and Resistant Vesical Equivalent.