Second line therapy with dorzolamide/timolol or latanoprost/timolol fixed combination versus adding dorzolamide/timolol fixed combination to latanoprost monotherapy

Abstract

Objective: To evaluate open-angle glaucoma patients, who were insufficiently controlled on latanoprost monotherapy, to determine the 24-hour intraocular pressure (IOP) efficacy and safety when changing them to dorzolamide/timolol (DTFC) or latanoprost/timolol fixed combination (LTFC) or adding DTFC.

Methods: A prospective, observer-masked, placebo-controlled, crossover, comparison.

Consecutive adults with primary open-angle or exfoliative glaucoma who exhibit a mean baseline IOP > 21 mm Hg on latanoprost monotherapy were randomized for 3 months to: DTFC, LTFC or DTFC and latanoprost. Patients were then crossed over to the next treatment for Periods 2 and 3. At the end of the latanoprost run-in and after each 3-month treatment period patients underwent 24-hour IOP monitoring.

Results: 31 patients completed this study. All 3 adjunctive therapies significantly reduced the IOP at each time point and for the mean 24-hour curve, except at 18:00 and 02:00 with DTFC and 02:00 with LTFC.

Conclusions: This study showed DTFC, LTFC and the addition of DTFC to latanoprost significantly decrease the IOP compared to latanoprost alone, but the latter therapy regime obtains the greatest IOP reduction.