Efficacy and tolerability of bimatoprost versus travoprost in patients previously on latanoprost: a 3-month, randomised, masked-evaluator, multicentre study

J A Kammer, B Katzman, S L Ackerman, D A Hollander, J A Kammer, B Katzman, S L Ackerman, D A Hollander

Abstract

Aim: 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 month and 3 months of replacement therapy.

Results: Baseline mean diurnal IOP on latanoprost was similar between groups. The mean diurnal IOP was significantly lower with bimatoprost than with travoprost at 1 month (p = 0.009) and 3 months (p = 0.024). Overall, 22.0% of bimatoprost patients versus 12.1% of travoprost patients achieved a > or =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 to 2.5) mm Hg (11.0%) with bimatoprost and 1.4 (95% CI 0.9 to 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 > or =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 a 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.

Conflict of interest statement

Competing interests: JAK has received lecture honoraria from Allergan and has been reimbursed for attending conferences. BK was involved in this study sponsored by Allergan and declares no other financial interests. SLA attended and was compensated for a 2-day consultants’ meeting sponsored by Alcon Labs in 2008. The practice is also involved in various clinical research projects sponsored by Allergan, Alcon, Pfizer and ISTA. From time to time, it may have a similar involvement with other pharmaceutical and device companies. DAH in an employee of Allergan.

Figures

Figure 1
Figure 1
Mean diurnal intraocular pressure (IOP) in each treatment group at latanoprost-treated baseline and after 1 and 3 months of bimatoprost or travoprost replacement therapy. Error bars represent the standard error of the mean. *p = 0.009 versus travoprost; +p = 0.024 versus travoprost.
Figure 2
Figure 2
Mean diurnal intraocular pressure (IOP) at latanoprost-treated baseline and after 1 and 3 months of bimatoprost or travoprost replacement therapy for patients with baseline IOP+p<0.001 versus travoprost.
Figure 3
Figure 3
Percentage of patients with at least a one-grade increase from baseline in biomicroscopic conjunctival hyperaemia and corneal punctate keratitis scores. Most patients in each group had none-to-trace conjunctival hyperaemia and punctate keratitis on latanoprost baseline (bimatoprost: 93%, 96%; travoprost: 88%, 95%, respectively).

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