Comparison of prostaglandin analogue, beta-blockers and prostaglandin analogue/beta-blockers fixed combination in patients with primary open-angle glaucoma

Abstract

To compare intraocular pressure (IOP)-lowering efficacy of prostaglandin analogue, beta-blocker and prostaglandin analogue/beta-blocker fixed combination ophthalmic solution in patients with open-angle glaucoma. In this prospective, multicentre, randomized clinical trial, 120 qualifying patients received prostaglandin/beta-blocker once daily (n = 40), prostaglandin analogue once daily in the evening (n = 40) or beta-blocker twice daily (n = 40). Efficacy was compared across treatment groups over 1 year. Mean IOP at the first visit in the prostaglandin group was 26.6 mmHg (SD ± 2.0 mmHg), in beta-blockers group was 25.9 mmHg (SD ± 1.7 mmHg) and in prostaglandin/beta-blockers group was 26.3 mmHg (SD ± 2.0 mmHg). Mean IOP at the seventh visit (after 1 year) in the prostaglandin group was 19.8 mmHg (SD ± 1.3 mmHg), in beta-blockers group was 21.3 mmHg (SD ± 1.2 mmHg) and in prostaglandin/beta-blockers group was 18.4 mmHg (SD ± 1.3 mmHg; range: 16.0–21.0 mmHg). There was no statistically significant difference of IOP in both eyes on seventh visit by groups (KW = 113.0, p < 0.0001). Over 1 year of treatment, prostaglandin analogue/beta-blockers produced clinically relevant IOP reductions in patients with open-angle glaucoma that were greater than those produced by either prostaglandin analogue or beta-blockers alone. Prostaglandin analogue/beta-blocker provides both more effective IOP reduction than its components and the benefits of once-daily dosing.