Original ArticleIntraocular Pressure–Lowering Effects of All Commonly Used Glaucoma Drugs: A Meta-analysis of Randomized Clinical Trials
Section snippets
Materials and Methods
Articles were identified through a computerized search in Medline, Embase, and the Cochrane Controlled Trials Register. The search strategy, as advised by the Cochrane Collaboration, was used to identify randomized clinical trials.5, 6, 7 The keywords for medication were betaxolol, timolol, dorzolamide, brinzolamide, brimonidine, latanoprost, travoprost, and bimatoprost and their commercial names. The keywords for the disease were ocul* and hypert*, explode Ocular-hypertension/all subheadings,
Study Eligibility and Quality
The flow of the randomized clinical trials included in our analysis is shown in Figure 1. The characteristics of the eligible studies are summarized in Table 3. In general, the quality of included studies was high (Table 3). The mean total quality score for all studies is 14.2, on a scale from 0 to 20 (interquartile range, 13–16). Twenty-six articles were included, which reported on 27 trials; 56 arms were reporting peak measurements; and 52 arms were reporting trough measurements. We included
Discussion
Our results confirm that the 8 drugs evaluated in this meta-analysis lower IOP more effectively than a placebo. The highest reduction in IOP at peak was achieved by bimatoprost (33%), followed by latanoprost, travoprost, timolol, brimonidine, betaxolol, dorzolamide, brinzolamide (17%), and a placebo (5%). At trough, the order is travoprost (31%), bimatoprost, latanoprost, timolol, betaxolol, brimonidine, brinzolamide, dorzolamide (17%), and a placebo (5%). However, the differences between
References (35)
- et al.
Meta-analysis of the effect of latanoprost and brimonidine on intraocular pressure in the treatment of glaucoma
Clin Ther
(2000) - et al.
Publication bias in clinical research
Lancet
(1991) - et al.
The Delphi lista criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus
J Clin Epidemiol
(1998) - et al.
When can a clinical trial be called “randomized”?
Vaccine
(2003) - et al.
Ensuring the comparability of comparison groupsis randomization enough?
Control Clin Trials
(2004) - et al.
Comparison of once- or twice-daily bimatoprost with twice-daily timolol in patients with elevated IOP: a 3-month clinical trial
Ophthalmology
(2001) - et al.
A six-month randomized clinical trial comparing the intraocular pressure-lowering efficacy of bimatoprost and latanoprost in patients with ocular hypertension or glaucoma
Am J Ophthalmol
(2003) - et al.
Travoprost compared with latanoprost and timolol in patients with open-angle glaucoma or ocular hypertension
Am J Ophthalmol
(2001) - et al.
A comparison of latanoprost, bimatoprost, and travoprost in patients with elevated intraocular pressurea 12-week, randomized, masked-evaluator multicenter study
Am J Ophthalmol
(2003) - et al.
Efficacy and safety of bimatoprost in patients with elevated intraocular pressurea 30-day comparison with latanoprost
Surv Ophthalmol
(2001)
A randomized trial comparing the dorzolamide-timolol combination given twice daily to monotherapy with timolol and dorzolamide
Ophthalmology
The efficacy and safety of brinzolamide 1% ophthalmic suspension (Azopt) as a primary therapy in patients with open-angle glaucoma or ocular hypertension
Surv Ophthalmol
Assessing the quality of reports of randomized clinical trialsis blinding necessary?
Control Clin Trials
Selecting the language of the publications included in a meta-analysisis there a Tower of Babel bias?
J Clin Epidemiol
Completeness of reporting of trials published in languages other than Englishimplications for conduct and reporting of systematic reviews
Lancet
Number of people with glaucoma worldwide
Br J Ophthalmol
Terminology and Guidelines for Glaucoma
Cited by (0)
Manuscript no. 2004-170.
Financial support: Dutch Health Care Insurance Council, Diemen, The Netherlands.
No author has any commercial (proprietary or financial) interest in any drug mentioned in the article.