Timolol 0.5%/dorzolamide 2% fixed combination vs timolol maleate 0.5% and unoprostone 0.15% given twice daily to patients with primary open-angle glaucoma or ocular hypertension

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Objective To compare the efficacy and safety of timolol 0.5%/dorzolamide 2% fixed combination vs timolol maleate 0.5% and unoprostone 0.15% given twice daily. Design Prospective multicenter, randomized, double-masked, crossover comparison study. Methods Primary open-angle glaucoma or ocular hypertension patients were randomly assigned to one of the treatment groups for a 6-week treatment period and then crossed over to the opposite treatment. Diurnal curve testing was performed at 8:00 am, 10:00 am, 4:00 pm, 6:00 pm, and 8:00 pm at baseline and the end of each treatment period. The run-in medicine was timolol twice daily for 28 days. Results Thirty-two patients completed this trial. The baseline trough pressure was 24.3 ± 3.0 mm Hg, and the diurnal curve was 23.4 ± 3.2 mm Hg. For the fixed combination the treatment trough pressure was 20.8 ± 4.1 mm Hg and the diurnal curve was 19.6 ± 3.6 mm Hg, whereas timolol and unoprostone concomitant therapy showed a treatment trough pressure of 20.1 ± 4.5 mm Hg and a diurnal pressure of 19.8 ± 4.1 mm Hg. There was no significant difference between treatment groups at any time point, for the diurnal curve, or in the extended reduction from baseline. There was no difference between treatment groups regarding ocular and systemic unsolicited or solicited adverse events. Burning, stinging, and conjunctival hyperemia were the adverse events most noted. There were no serious adverse events during this trial. Conclusions This study suggests that both timolol/dorzolamide 2% fixed combination and concomitant timolol maleate 0.5% and unoprostone 0.15% therapy provide similar efficacy and safety throughout the daytime diurnal curve.