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Comparison of the intraocular pressure lowering effect of latanoprost and a fixed combination of timolol-pilocarpine eye drops in patients insufficiently controlled with β adrenergic antagonists
  1. Jean-Philippe Nordmanna,
  2. Mats Söderströmb,
  3. Jean-François Roulandc,d,
  4. François Malecaze,
  5. the French Latanoprost Study Group,
  6. the Swedish Latanoprost Study Group
  1. aDepartment of Ophthalmology, Hôpital des Quinze-Vingts, Paris, France, bDepartment of Ophthalmology, Huddinge University Hospital, Sweden, cDepartment of Ophthalmology, Hôpital Huriez, Lille, France, dDepartment of Ophthalmology, Hôpital Purpan, Toulouse, France
  1. Jean-Philippe Nordmann, MD, PhD, Department of Ophthalmology, Hôpital des Quinze-Vingts, 28 rue de Charenton, 75012 Paris, France


AIMS To compare the effect on intraocular pressure (IOP) of latanoprost monotherapy and timolol-pilocarpine in patients with glaucoma or ocular hypertension with inadequately controlled IOP on topical β adrenergic antagonists.

METHODS This was a multicentre, randomised, observer masked, 6 week study performed in France and Sweden. 23 centres enrolled 237 patients with glaucoma or ocular hypertension and an IOP of at least 22 mm Hg on treatment with topical β adrenergic antagonists, alone or in combination. After a 21 day run in period on timolol 0.5% twice daily, patients were randomised either to latanoprost 0.005% once daily or to a fixed combination of timolol-pilocarpine twice daily. Changes in mean diurnal IOP from the baseline to the 6 week visit were determined with an analysis of covariance.

RESULTS Mean diurnal IOP was statistically significantly decreased from baseline in both groups (p<0.001). Switching to latanoprost treatment reduced mean diurnal IOP by 5.4 (SEM 0.3) mm Hg (ANCOVA −22%) and switching to timolol-pilocarpine treatment reduced mean diurnal IOP by 4.9 (0.4) mm Hg (−20%). Blurred vision, decreased visual acuity, decreased twilight vision, and headache were statistically significantly more frequent in the timolol-pilocarpine group.

CONCLUSIONS Latanoprost monotherapy was at least as effective as fixed combination timolol-pilocarpine twice daily treatment in reducing mean diurnal IOP in patients not adequately controlled on topical β adrenergic antagonists. Latanoprost was better tolerated than timolol-pilocarpine regarding side effects. These results indicate that a switch to latanoprost monotherapy can be attempted before combination therapy is initiated.

  • latanoprost
  • timolol-pilocarpine
  • intraocular pressure
  • glaucoma

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