The efficacy and
safety of 0,005% latanoprost once daily was compared with 0,2% brimonidine
twice daily in patients with unilateral or bilateral open-angle glaucoma or
ocular hypertension with an IOP >20 mmHg currently on monotherapy or dual
therapy. Altohether 379 patients were enrolled in this 6-month, randomized,
observed-masked multicenter study and subjected to appropriate washout period.
The morning IOP (10 a.m.) was recorded 12 h after the administration of
latanoprost and 2 h after brimonidine. The afternoon (5 p.m.) measurements were
recorded 19 h after latanoprost and 9 h after brimonidine. The mean IOP
reduction at 6 months was compared between the treatments. There were
altogether 48 patients withdravals (5 in latanoprost and 43 in brimonidine
group). The most common reason reasons were inadequately controlled IOP (2 vs
12) and ocular allergy (0 vs 14). After 6 month of treatment latanoprost
reduced the mean IOP by 7.1 mmHg (28%) compared with 5,2 mmHg (21%)for
brimonidine. This difference of 1,9 mmHg was statistically highly significant.
(p<0,001, ANCOVA). A mean reduction of IOP > 30% was reached by 42% of
latanoprost treated patients compared with 22% of brimonidine-treated
patients. Reduction of IOP less
than 15% (non-responders) was recorded by 12% of latanoprost-treated patients
and by 32% of brimonidine-treated patients. Systemic adverse events
(p<0,001) and ocular allergy (p=0,005) were significantly more frequently
reported in brimonidine treated patients.