Purpose: To evaluate the efficacy and safety of replacing latanoprost with another prostaglandin analogue (PGA) in patients with glaucoma or ocular hypertension requiring additional intraocular pressure (IOP) lowering while on latanoprost.
Methods: Prospective, randomised, investigator-masked, multicentre clinical trial. Patients on latanoprost 0.005% monotherapy requiring additional IOP lowering discontinued latanoprost and were randomised to bimatoprost 0.03% (n=131) or travoprost 0.004% (n=135). IOP was measured at latanoprost-treated baseline and after 1 and 3 months of replacement therapy.
Results: Baseline mean diurnal IOP on latanoprost was similar between groups. Mean diurnal IOP was significantly lower with bimatoprost than with travoprost at 1 (p=0.009) and 3 months (p=0.024). Overall, 22.0% of bimatoprost patients vs 12.1% of travoprost patients achieved a ≥15% reduction in diurnal IOP from latanoprost-treated baseline at both months 1 and 3 (p=0.033). At month 3, the additional mean diurnal IOP reduction from latanoprost-treated baseline was 2.1 (95% CI: 1.7, 2.5) mm Hg (11.0%) with bimatoprost and 1.4 (95% CI: 0.9, 1.8) mm Hg (7.4%) with travoprost (p=0.024). At 3 months, 11.5% of bimatoprost and 16.5% of travoprost patients demonstrated a ≥1-grade increase in physician-graded conjunctival hyperaemia (p=0.288). Hyperaemia was reported as a treatment-related adverse event in 3.1% of bimatoprost and 1.5% of travoprost patients (p=0.445).
Conclusion: Patients on latanoprost requiring lower IOP achieved greater additional short-term diurnal IOP reduction when latanoprost was replaced by bimatoprost compared with travoprost. Low rates of hyperaemia were observed in patients treated with bimatoprost or travoprost after switching from latanoprost.