dorzolamide-timolol-combination and Glaucoma--Open-Angle

Azarga is a new fixed combination product that consists of the carbonic anhydrase inhibitor brinzolamide 1% and the betablocker timolol 0,5%. Its efficacy in lowering intraocular pressure is similar to that of Cosopt, a fixed combination that combines another carbonic anhydrase inhibitor (eg dorzolamide 2%) with the betablocker timolol 0,5%. The main difference between these two ocular hypotensive agents lies in their safety profiles with Cosopt causing more ocular discomfort to appear while instilling (burning,stinging and smarting sensations) probably due to the differences between the pH of these two fixed combinations agents. Its similar efficacy and enhanced tolerability compared with Cosopt make Azarga represent a resonable alternative for the patients who do not achieve an adequate intraocular pressure control while treating with a monotherapeutic agent.

Topics: Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Drug Combinations; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Ophthalmic Solutions; Randomized Controlled Trials as Topic; Sulfonamides; Thiazines; Thiophenes; Timolol; Treatment Outcome; Vision, Ocular

Modern fixed-combination products simplify medication dose regimen without sacrificing their effectiveness.Potential benefits of the therapy with fixed-combination products are enhanced tolerability increased convenience,better compliance,cost and time economy and removal of the wash out effect. Regarding intraocular pressure lowering effect, fixed-combination agents are superior to monotherapy with the two medication components, with the exception of Duotrav that is not superior to travoprost action.Fixed-combination products are noninferior to concomitant administration of the two components of medication (nonfixed-combination agents) relative to their ocular hypotensive efficacy with the exception of Ganfort that is however inferior to concurrent administration of both the bimatoprost and timolol.

Topics: Amides; Antihypertensive Agents; Bimatoprost; Brimonidine Tartrate, Timolol Maleate Drug Combination; Carbonic Anhydrase Inhibitors; Cloprostenol; Drug Combinations; Drug Therapy, Combination; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Ophthalmic Solutions; Prostaglandins F, Synthetic; Quinoxalines; Sulfonamides; Thiazines; Thiophenes; Timolol; Travoprost; Treatment Outcome

To compare the additive effects and safety of 1% brinzolamide/0.5% timolol fixed combination (BTFC) versus the low-dose regimen of 1% dorzolamide/0.5% timolol fixed combination (DTFC) in patients with open-angle glaucoma and ocular hypertension (OAG/OH) following treatment with prostaglandin analogues (PGAs).. A prospective, randomized, double-masked, multicentre, parallel-group and active-controlled study included 201 Japanese OAG/OH patients who had been treated with PGA. Efficacy was assessed as the change in intra-ocular pressure (IOP) from baseline after weeks 4 and 8. Safety was assessed with adverse event rates, ocular discomfort score, blur scale, blood pressure and heart rates, best-corrected visual acuity (BCVA) and slit lamp examinations.. Intra-ocular pressure (IOP) change from baseline at 9 AM/11 AM pooled over the 8 weeks was -3.3/-3.3 mmHg in the BTFC group and -2.9/-3.4 mmHg in the DTFC group, demonstrating non-inferiority of BTFC to DTFC. Ocular irritation was frequently seen in DTFC group. Although blurred vision was frequently seen in BTFC group, it was transient and blurring became the equivalent 3 min after instillation between two groups. No noteworthy issue was observed in other safety outcome.. Non-inferiority of BTFC to DTFC in IOP reduction was demonstrated after adding onto PGA therapy in Japanese OAG/OH patients. Although the score of blurred vision was transiently higher in BTFC than DTFC, treatment difference decreased and disappeared with time. Thus, BTFC can be considered as a safe and effective agent for glaucoma treatment.

Topics: Dose-Response Relationship, Drug; Double-Blind Method; Drug Combinations; Follow-Up Studies; Glaucoma, Open-Angle; Intraocular Pressure; Ocular Hypertension; Ophthalmic Solutions; Prospective Studies; Prostaglandins, Synthetic; Sulfonamides; Thiazines; Thiophenes; Time Factors; Timolol; Tonometry, Ocular; Treatment Outcome

To compare the efficiency of brinzolamide/brimonidine fixed combination vs the dorzolamide/timolol fixed combination.. Forty-four eyes of 44 patients were divided in 2 groups treated either with dorzolamide/timolol twice a day (group A) or with brinzolamide/brimonidine twice a day (group B). Complete ophthalmic examination including Goldmann applanation tonometry was performed before treatment administration and 1, 4, 8, and 12 weeks afterwards. The intraocular pressure (IOP) was measured twice a day (morning at 9 AM and afternoon at 4 PM).. At the end of the follow-up period (12 weeks), mean morning IOP reduction was 7.0 ± 2.8 mm Hg in group A and 8.4 ± 1.9 mm Hg in group B. A significant difference was found (p = 0.0343). In contrast, mean afternoon IOP reduction was 8.6 ± 2.7 mm Hg in group A and 7.9 ± 1.6 mm Hg in group B and no significant difference was found (p = 0.3413). No significant adverse effects were observed in either group.. Brinzolamide/brimonidine seems to be an effective and safe alternative β-blocker free fixed combination, especially for patients with comorbidities, having its own antihypertensive profile.

Topics: Aged; Antihypertensive Agents; Double-Blind Method; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Prospective Studies; Sulfonamides; Thiazines; Thiophenes; Timolol; Tonometry, Ocular; Treatment Outcome

The aim of the present study was to evaluate the 24-h efficacy, tolerability, and ocular surface health with preservative-free (PF) tafluprost and a PF triple drug regimen comprising tafluprost and dorzolamide/timolol fixed combination (DTFC) in open-angle glaucoma patients who were insufficiently controlled with preserved branded or generic latanoprost monotherapy and who exhibited signs or symptoms of ocular surface disease (OSD).. Prospective, observer-masked, crossover, comparison. Eligible consecutive open-angle glaucoma patients were randomized to either PF tafluprost or the triple PF regimen for 3 months. They were then crossed over to the opposite therapy for another 3 months. At the end of the latanoprost run-in period and after each PF treatment period, patients underwent habitual 24-h intraocular pressure (IOP) monitoring with Goldmann tonometry in the sitting position (at 10:00, 14:00, 18:00, and 22:00) and Perkins tonometry in the supine position (at 02:00 and 06:00). Tolerability and selected ocular surface parameters were evaluated at baseline and the end of each treatment period.. Forty-three open-angle glaucoma patients completed the trial. Mean 24-h IOP on preserved latanoprost was 22.2 ± 3.9 mmHg. Compared with latanoprost monotherapy, PF tafluprost obtained a greater reduction in mean, peak, and fluctuation of 24-h IOP including the 02:00 and 06:00 time points (P < 0.05). With the exception of 24-h fluctuation, the triple PF regimen provided significantly lower IOP parameters than latanoprost or PF tafluprost (P < 0.001). Finally, PF tafluprost therapy displayed significantly improved tear film break-up times (6.7 vs 6.0 s), corneal staining (1.3 vs 2.2), and Schirmer I test results (9.1 vs 8.2 mm) compared with the preserved latanoprost baseline (all P < 0.01). The triple PF regimen demonstrated similar tear film break-up times (6.1 vs 6.0 s) and Schirmer I test results (8.2 vs 8.2 mm) to latanoprost, but revealed a significant improvement in the corneal stain test (1.7 vs 2.2; P < 0.001).. In this trial PF tafluprost therapy provided statistically greater 24-h efficacy and improved tolerability compared with preserved latanoprost. The combination of PF tafluprost and PF dorzolamide/timolol fixed combination was statistically and clinically more efficacious than both monotherapies and demonstrated similar ocular surface characteristics to preserved latanoprost monotherapy.. ClinicalTrials.gov (NCT02802137).. Santen.

Topics: Aged; Aged, 80 and over; Antihypertensive Agents; Cross-Over Studies; Drug Combinations; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Preservatives, Pharmaceutical; Prospective Studies; Prostaglandins F; Prostaglandins F, Synthetic; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular; Treatment Outcome

To compare the efficacy and tolerability of brinzolamide/timolol (BT) and dorzolamide/timolol (DT) fixed combinations on intraocular pressure (IOP) reduction.. Patients with primary open angle glaucoma or normal tension glaucoma were randomized to receive either BT or DT. IOPs were measured at baseline, 2 weeks, and 1, 2, and 3 months. The primary outcome measures were the mean change in IOP from baseline at each visit. Secondary outcome measures included the tolerability of each fixed combination.. Seventy-three patients (73 eyes) were included; 37 eyes in BT group and 36 eyes in DT group. Baseline mean IOP were 24.14 ± 4.5 and 29.53 ± 6 mmHg for BT and DT, respectively (P < 0.001). Both BT and DT provided statistically significant mean IOP reductions from baseline values within each group at all study visits (P < 0.001). DT provided greater mean IOP reductions from baseline than BT at each visit which was statistically significant at 2 weeks (P = 0.037). Mean percentage of IOP reduction was 24.35% and 46.33% at 2 weeks (P < 0.001), and 24.65% and 47% at 3 months (P < 0.001) for BT and DT, respectively. Patients' tolerability appeared to be better for DT than for BT with complete ocular comfort without any ocular adverse effects in 31 patients (81.1%) in DT group and 11 patients (29.7%) in BT group (P < 0.001).. Both drops provide effective IOP reduction which was greater, and patients were more likely to achieve lower target pressures with DT than with BT.

Topics: Administration, Topical; Adolescent; Adult; Aged; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Drug Combinations; Egypt; Female; Glaucoma, Open-Angle; Hospitals, University; Humans; Intraocular Pressure; Low Tension Glaucoma; Male; Middle Aged; Ophthalmic Solutions; Prospective Studies; Sulfonamides; Thiazines; Thiophenes; Timolol; Tonometry, Ocular

This study evaluated the effects of acetazolamide, latanoprost, travoprost, bimatoprost, brimonidine, brinzolamide, and timolol on pain during phacoemulsification cataract surgery.. This prospective randomized comparative study included 323 eyes of 323 patients with no history of intraocular surgery or chronic eye disease who underwent uncomplicated phacoemulsification cataract surgery and foldable intraocular lens implantation under topical anesthesia. Patients were divided into 8 groups according to the preoperative prophylactic intraocular pressure (IOP)-lowering medication. The intraoperative pain was assessed postoperatively using a visual analog pain scale. The Kruskal-Wallis test investigated the differences in the visual analog pain-scale scores of the groups, and the Mann-Whitney U test investigated the pairwise comparison of the groups.. The median visual analog pain-scale score of the group that did not receive any IOP-lowering medication was 2.0±1.89. The brimonidine group exhibited the lowest visual analog pain-scale scores, and the prostanoids, especially the bimatoprost group, demonstrated the highest visual analog pain-scale scores (median±standard deviation were 0.0±1.50 and 2.0±1.91, respectively). The median visual analog pain-scale scores of the acetazolamide, latanoprost, travoprost, brinzolamide, and timolol groups were 0.0±1.62, 2.0±1.67, 2.0±1.73, 0.0±1.66, and 1.0±1.54, respectively. A pairwise comparison using the Mann-Whitney U test with Bonferroni correction revealed significant differences between the groups of acetozolamide and travoprost (p=0.001), acetozolamide and bimatoprost (p<0.001), travoprost and brimonidine (p<0.001), bimatoprost and brimonidine (p<0.001), and bimatoprost and timolol (p=0.001).. Prophylactic application of the IOP-lowering medication may alter the pain sensation during phacoemulsification cataract surgery.

Topics: Acetazolamide; Adult; Aged; Aged, 80 and over; Amides; Antihypertensive Agents; Bimatoprost; Brimonidine Tartrate; Cataract; Cloprostenol; Combined Modality Therapy; Drug Combinations; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Pain; Phacoemulsification; Postoperative Period; Prospective Studies; Prostaglandins F, Synthetic; Quinoxalines; Sulfonamides; Thiophenes; Timolol; Travoprost

To assess whether dorzolamide 2%-timolol 0.5% (D/T) and/or brimonidine 0.2%-timolol 0.5% (B/T) alters retinal vascular autoregulation (RVA) and seated ocular perfusion pressure (sOPP) in primary open angle glaucoma (POAG) patients who demonstrate retinal vascular dysregulation (RVD) on timolol 0.5% alone.. In this prospective, observer-masked, crossover study, 21 POAG patients with untreated intraocular pressure (IOP) >21 mmHg were treated for 6 weeks with timolol 0.5%. Subsequently, we measured inferior temporal retinal artery blood flow in the left eye with subjects seated and then while reclined for 30 min using the Canon Laser Blood Flowmeter. Subjects with a change in retinal blood flow in response to posture change outside of the range previously found in healthy subjects were designated as having RVD and randomized to either D/T or B/T for 6 weeks and re-tested. This was followed by treatment with the opposite medication.. Seven of the 21 subjects demonstrated RVD in response to posture change following timolol 0.5%. Multiple linear regression analysis indicated that lower sOPP was the main determinant of RVD (P=0.033). After treatment with D/T, all 7 converted from RVD to normal RVA status (P=0.001). Four of 6 subjects showed a similar return to normal RVA following B/T (P=0.066). Mid-morning sOPP was 41.1±5.5 mmHg post-timolol, 46.3±6.5 mmHg post-D/T, and 38.6±6.0 mmHg post-B/T (D/T vs. B/T, P=0.026).. D/T significantly improved RVA in POAG patients exhibiting RVD while on timolol 0.5% alone. D/T also increased sOPP compared to B/T. There was no significant difference (P=0.37) between D/T and B/T in improving RVA.

Topics: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Brimonidine Tartrate; Cross-Over Studies; Drug Combinations; Eye; Female; Glaucoma, Open-Angle; Homeostasis; Humans; Intraocular Pressure; Male; Middle Aged; Prospective Studies; Quinoxalines; Regional Blood Flow; Sulfonamides; Thiophenes; Timolol

To determine the adjunctive 24-h efficacy obtained with brinzolamide/timolol, or brimonidine/timolol fixed combinations (FCs) in open-angle glaucoma patients insufficiently controlled on travoprost monotherapy.. Prospective, observer-masked, active controlled, crossover, comparison. Qualified primary open-angle or exfoliative glaucoma patients with a baseline intraocular pressure (IOP) >18 mm Hg at 10:00 on travoprost monotherapy were randomized for 3 months to either brinzolamide/timolol, or brimonidine/timolol FC therapy adjunct to travoprost. Patients were then crossed-over to the opposite therapy for another 3 months. At baseline and at the end of each treatment period, the patients underwent 24-h IOP monitoring.. Fifty patients completed the study. The mean 24-h baseline IOP on travoprost monotherapy was 20.1 mm Hg [95% confidence interval (CI): 19.6, 20.7 mm Hg]. Both adjunctive FC therapies significantly reduced the IOP at each time point and for the mean 24-h IOP (P<0.001) compared with travoprost monotherapy. Brinzolamide/timolol FC provided a significantly lower mean 24-h IOP (17.2 mm Hg, 95% CI: 16.4, 17.9 mm Hg) than brimonidine/timolol FC (18.0 mm Hg, 95% CI: 17.3, 18.8 mm Hg) (P<0.001). For all the 3 timepoints between 18:00 and 02:00, the brinzolamide/timolol FC provided a significantly lower IOP than the brimonidine/timolol FC (P≤0.036). For the other 3 timepoints, no significant differences were detected.. This study demonstrated that both FCs provide statistically and clinically significant incremental 24-h IOP lowering to travoprost monotherapy. The brinzolamide/timolol FC however achieves a better mean 24-h IOP control owing to the greater efficacy in late afternoon and during the night.

Topics: Aged; Aged, 80 and over; Antihypertensive Agents; Brimonidine Tartrate; Cloprostenol; Cross-Over Studies; Drug Combinations; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Prospective Studies; Quinoxalines; Sulfonamides; Thiophenes; Time Factors; Timolol; Travoprost

The aim of this study was to compare the intraocular pressure (IOP) lowering efficacy and to determine patient preference based on ocular discomfort with fixed combination brinzolamide/timolol and fixed combination dorzolamide/timolol in patients with open-angle glaucoma or ocular hypertension who required a change in therapy due to elevated IOP while receiving IOP-lowering medication.. This was a 3-month, randomized, double-blinded, active-controlled, parallel-group trial. Patients had open-angle glaucoma or ocular hypertension, which could not be controlled with monotherapy and were randomized to twice daily therapy with either brinzolamide 1%/timolol 0.5% or dorzolamide 2%/timolol 0.5%. IOP assessments were taken at 8 AM, 10 AM, and 4 PM at week 2 as well as at months 1, 2, and 3. Patients completed ocular discomfort assessments (based on stinging, burning, feeling of heat or warmth, or sharp pain) on their current IOP lowering therapy at baseline.. Of the 114 patients enrolled, 57 received Brinz/Tim and 57 received Dorz/Tim twice daily. Both medications produced statistically relevant IOP reductions, which were similar in both groups at each visit. The IOP reductions with Brinz/Tim ranged from 6.42 to 9.74 mmHg (26.09%-37.46%), whereas Dorz/Tim produced mean IOP reductions ranging from 8.16 to 12.41 mmHg (31.19%-41.44%) (P>0.05). Brinz/Tim showed significantly less ocular irritation (0.5% vs. 15.7%, respectively; P=0.0004) than Dorz/Tim.. Both Brinz/Tim and Dorz/Tim showed similar significant and clinically relevant IOP-lowering efficacy, whereas Brinz/Tim provided superior outcomes in terms of ocular comfort.

Topics: Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Cross-Over Studies; Double-Blind Method; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Patient Preference; Sulfonamides; Thiazines; Thiophenes; Timolol; Treatment Outcome

The aim of this study was to evaluate intraocular pressure (IOP), retrobulbar blood flow (RBF), and ocular side effects after the application of topical dorzolamide/timolol fixed combination (DTFC) drops vs topical nebulized DTFC mist in patients with primary open-angle glaucoma.. A total of 15 POAG patients were enrolled in a prospective study. Retrobulbar blood flow was measured in the ophthalmic (OA) and central retinal (CRA) arteries using color Doppler imaging. DTFC mist or drops were applied to the experimental eye, and it was examined after 15 and 60 minutes. DTFC mist was applied 6 times for 30 seconds using a misting device.. DTFC mist significantly increased peak-systolic (PSV) and end-diastolic (EDV) velocities after 15 and 60 minutes in both the arteries (OA: increase of 12.5% and 9.6% in PSV, P=0.01; increase of 25.8% and 23.1% in EDV, P=0.03; CRA: increase of 11.5% and 8.7% in PSV, increase of 32% and 21.6% in EDV, respectively, P<0.05). DTFC drops had a similar effect on PSV and EDV in the CRA after 15 and 60 minutes (increase of 8.1% and 9.6% in PSV; increase of 17.1% and 23% in EDV, respectively, P=0.03), but a significant effect on PSV and EDV in the OA was documented only after 15 minutes (increase of 9% and 21.4%, respectively, P=0.02). DTFC mist reduced the resistance index in the CRA after 15 and 60 minutes (decrease of 8.5% and 10.2%, respectively, P=0.04). Both methodologies showed a significant decrease in IOP after 15 and 60 minutes (P<0.05). All patients complained of ocular irritation after drop application, and 1 patient complained of general weakness after mist treatment.. Nebulized DTFC mist significantly reduced IOP and increased blood flow in the OA and the CRA, causing no ocular irritation as compared with traditional DTFC drop methodology.

Topics: Adult; Aged; Antihypertensive Agents; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Nebulizers and Vaporizers; Ophthalmic Solutions; Orbit; Regional Blood Flow; Sulfonamides; Thiophenes; Timolol

The aim of this study is to compare the 24-hour efficacy of dorzolamide/timolol-fixed combination (DTFC) and brimonidine/timolol-fixed combination (BTFC) in primary open-angle glaucoma (POAG).. One eye each of 77 POAG patients was included in this prospective, observer-masked, crossover comparison. Following a 2-month timolol run-in period, patients had three intraocular pressure (IOP) measurements at 1000, 1200 and 1400 h while on timolol treatment. Patients showing at least a 20% IOP reduction on timolol were randomised to 3 months of therapy with DTFC or BTFC, and then were crossed over to the opposite therapy.. Sixty POAG patients completed the study. The mean 24-hour IOP was significantly reduced with both the fixed combinations compared with the timolol-treated diurnal IOP (P < 0.001). When the two fixed combinations were compared directly, DTFC demonstrated a lower mean 24-hour IOP level as compared with BTFC (mean difference: -0.7 mm Hg, 95% confidence interval (CI): (-1.0, -0.3), P < 0.001). At two individual time points, DTFC significantly reduced IOP more than BTFC: at 1800 h (-1.0 mm Hg, 95% CI (-1.6,-0.5), P = 0.001) and at 0200 (-0.9 mm Hg, 95% CI: (-1.4,-0.5), P = 0.001). No significant difference existed for the other time points.. Both the fixed combinations significantly reduce 24-hour IOP in POAG. DTFC provided significantly better 24-hour efficacy.

Topics: Aged; Antihypertensive Agents; Brimonidine Tartrate; Cross-Over Studies; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Medication Adherence; Prospective Studies; Quinoxalines; Sulfonamides; Thiophenes; Time Factors; Timolol; Treatment Outcome

To examine the comparative short-term effects of brimonidine/timolol and dorzolamide/timolol on ocular perfusion pressure and retrobulbar blood flow in patients with primary open angle glaucoma (OAG).. In a prospective, randomized, double-blind, crossover study, intraocular pressure (IOP), blood pressure (BP), ocular perfusion pressure (OPP), and retrobulbar hemodynamics were assessed in 15 patients with OAG (mean age 68.1 years, eight women) with well controlled IOP. IOP was measured by Goldman applanation tonometery and color Doppler imaging was utilized to assess the retrobulbar blood vessels before and 1 month after treatment with topical brimonidine/timolol and dorzolamide/timolol. Statistical analysis was performed by Friedman two-way analysis of variance by ranks and post-hoc Wilcoxon signed rank test for multiple comparisons with Holm's sequential Bonferroni procedure. P values <0.05 were considered statistically significant.. The Friedman test and subsequent post-hoc analysis indicated that IOP, BP, OPP, and retrobulbar blood flow velocities did not significantly differ between brimonidine/timolol and dorzolamide/timolol after 1-month treatment administration in patients with OAG and well controlled IOP.. In this cohort of patients with OAG, short-term treatment with brimonidine/timolol and dorzolamide/timolol results in similar effects on OPP and retrobulbar blood flow velocities.

Topics: Administration, Ophthalmic; Aged; Antihypertensive Agents; Blood Pressure; Brimonidine Tartrate; Cross-Over Studies; Double-Blind Method; Drug Combinations; Eye; Female; Glaucoma, Open-Angle; Hemodynamics; Humans; Intraocular Pressure; Male; Quinoxalines; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular

To investigate the ocular hypotensive effect and safety of dorzolamide hydrochloride 1 %/timolol maleate 0.5 % fixed-combination eye drops.. The study cohort comprised 34 patients with either primary open-angle glaucoma or ocular hypertension who were being concomitantly treated with dorzolamide hydrochloride 1 % eye drops and timolol maleate 0.5 % eye drops. The dorzolamide hydrochloride 1 % and timolol maleate 0.5 % eye drops were replaced with dorzolamide hydrochloride 1 %/timolol maleate 0.5 % fixed-combination eye drops without any washout period. The intraocular pressure (IOP) was evaluated both before and 1 and 3 months after the treatment change. The patients were asked to complete a questionnaire on adherence to the treatment protocol 1 month after the change in treatment.. The IOP was 15.5 ± 2.7 mmHg at the time of treatment change, 15.2 ± 2.7 mmHg at 1 month post-change, and 15.5 ± 2.9 mmHg at 3 months post-change, which is consistent with that before the treatment change (p = 0.286). Based on the completed questionnaire, following the treatment change, 50 % of patients felt a stinging sensation following administration of the eye drops and 11.8 % experienced blurred vision. In no case were the eye drops discontinued due to adverse reactions or insufficient IOP decrease.. The replacement of concomitant treatment with dorzolamide hydrochloride 1 % and timolol maleate 0.5 % eye drops with dorzolamide hydrochloride 1 %/timolol maleate 0.5 % fixed-combination eye drops improved protocol adherence and preserved the IOP.

Topics: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Drug Combinations; Drug Evaluation; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Medication Adherence; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Sulfonamides; Surveys and Questionnaires; Thiophenes; Timolol; Tonometry, Ocular

To compare the short-term effectiveness and ocular side-effects of fixed combinations of dorzolamide/timolol (DTFC) and brimonidine/timolol (BTFC) in patients with primary open-angle glaucoma (POAG). Forty-two eyes of 42 patients newly diagnosed with primary open-angle glaucoma were assessed prospectively. One of the two eyes was chosen randomly and treated with DTFC (2 × 1) for 4 weeks. The treatment was then stopped to allow a 4-week wash-out period. Following the wash-out period, the same eye was treated with BTFC (2 × 1) for 4 weeks. Intraocular pressure (IOP) values were measured before and after each treatment at 0800, 1,200 and 1,600 h. Tear function test results and ocular side-effects were also recorded. The mean baseline IOP values for DTFC and BTFC were 24.1 ± 1.8 and 24.6 ± 2.4 mmHg, respectively. The mean IOP values after 4 weeks of treatment with DTFC or BTFC were 17.1 ± 2.9 and 16.9 ± 2.5 mmHg, respectively. Both medications reduced IOP values significantly (P = 0.0000). The effectiveness of both medications was similar (P = 0.7363). Both combinations significantly reduced the amount of tear secretion and tear break-up time (P = 0.0000). Eye burning was more common with DTFC than with BTFC (P = 0.0182). Other adverse effects were observed at similar rates for both combinations. This study demonstrated that the IOP-reducing effects of DTFC and BTFC in patients with POAG are similar. The side-effect profile of BTFC is similar to that of DTFC. Lower occurrence of a burning sensation may improve patient compliance in the BTFC group.

Topics: Aged; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Patient Compliance; Prospective Studies; Sulfonamides; Thiophenes; Timolol; Treatment Outcome

The aim of this study was to compare the efficacy and tolerability of preservative-free (PF) and preservative-containing (PC) formulations of the dorzolamide/timolol fixed combination (COSOPT™) in patients with elevated intraocular pressure (IOP).. A parallel, randomized, double-masked study was conducted. After a 3-week run-in on timolol, patients with ocular hypertension, as confirmed by an IOP ≥22 mmHg, were randomized 1:1 to receive PF or PC dorzolamide/timolol twice daily for 12 weeks. IOP was measured at hour 0 (drug trough) and hour 2 (drug peak) at baseline (last day of 3-week timolol run-in), and weeks 2, 6 and 12.. A total of 261 patients were randomized. Mean baseline IOPs were 23.7 mmHg for both treatments at hour 0 and 21.2 mmHg for PF dorzolamide/timolol and 21.4 mmHg for PC dorzolamide/timolol at hour 2. At all study time points (trough and peak at weeks 2, 6, and 12), the difference between treatments in mean change from baseline IOP was <0.5 mmHg. The 95% confidence intervals for the estimated treatment difference (PF minus PC) in mean change from baseline IOP at week 12 was -0.86 to 0.23 mmHg for trough (primary endpoint) and -0.39 to 0.67 mmHg for peak (secondary endpoint). The most common adverse events were ocular burning/stinging, reported by 16.0% and 21.5% of patients receiving PF and PC dorzolamide/timolol respectively, and taste perversion, reported by 3.1% and 5.4% of patients receiving PF and PC dorzolamide/timolol respectively.. In patients with elevated IOP, PF and PC dorzolamide/timolol were equivalent in efficacy for change in trough and peak IOP, and had generally similar tolerability.

Topics: Antihypertensive Agents; Double-Blind Method; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Preservatives, Pharmaceutical; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular; Treatment Outcome

To examine whether the addition of dorzolamide to timolol monotherapy influences oxygen saturation in the human retina.. Non-invasive spectrophotometric retinal oximetry was used to measure oxygen saturation in retinal vessels. Twenty patients with open-angle glaucoma (11) and ocular hypertension (9) were recruited. The patients were randomised into receiving timolol monotherapy or dorzolamide-timolol combination for an 8-month test period, followed by a second test period, before which the patients switched treatments. Oximetry measurements were performed at 2-month intervals during each period. Of the 20 patients, 13 followed the study protocol into the second test period, and 10 managed all study visits.. The oxygen saturation in retinal vessels was stable within the test periods. The mean arteriolar saturation was 96 (2)% (mean (SD)) during timolol monotherapy and 97 (2)% during dorzolamide-timolol combination therapy (p = 0.17, all patients pooled, n = 13). Corresponding values in venules were 66 (5)% during timolol monotherapy and 65 (6)% during dorzolamide-timolol therapy (p = 0.13). Patients who started on dorzolamide-timolol combination showed a significant reduction in arteriolar (98 (2)% to 95 (2)%, p<0.01) and venular saturation (69 (5)% to 66 (6)%, p<0.05) when changing to timolol monotherapy.. Adding dorzolamide to timolol monotherapy has a minimal effect, but going from dorzolamide-timolol combination to timolol alone lowered arteriolar and venular oxygen saturation. The retinal oxygen saturation measurements show a high degree of stability over an extended period of time. Previous studies have suggested increased retinal and optic nerve blood flow with dorzolamide. Unchanged oxygen saturation and increased blood flow would indicate increased oxygen delivery to the retina.

Topics: Adolescent; Adult; Aged; Antihypertensive Agents; Blood Pressure; Double-Blind Method; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Oximetry; Oxygen; Retinal Vessels; Sulfonamides; Thiophenes; Timolol; Young Adult

To evaluate the 24-hour intraocular pressure (IOP)-lowering effect of latanoprost and the dorzolamide/timolol fixed combination (DTFC) after 2 and 6 months of treatment.. Randomized, prospective, crossover comparison.. Thirty-nine patients had primary open-angle glaucoma, and 14 patients had ocular hypertension.. After a 6-week washout period, patients were randomized to either 6 months of treatment with the DTFC twice daily or latanoprost every evening and then crossed over to the opposite treatment for an additional 6 months.. Mean 24-hour IOP after 2 and 6 months of treatment.. Fifty-three patients had an average 24-hour baseline IOP of 25.2+/-2.3 mmHg. After 6 months of treatment, 24-hour IOPs were 18.1+/-1.9 mmHg for the DTFC and 18.3+/-1.9 mmHg for latanoprost. Compared with 2 months of therapy, at 6 months the DTFC showed no significant change in mean 24-hour IOP, whereas latanoprost demonstrated a reduction of 0.3 mmHg (P = 0.01). The DTFC had more burning (P<0.001) and bitter taste (P = 0.01), whereas the latanoprost had more hypertrichosis (P = 0.02).. After 6 months of therapy, the DTFC and latanoprost have clinically similar 24-hour IOP-lowering efficacies.

Topics: Antihypertensive Agents; Circadian Rhythm; Cross-Over Studies; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Prospective Studies; Prostaglandins F, Synthetic; Sulfonamides; Therapeutic Equivalency; Thiophenes; Time Factors; Timolol; Tonometry, Ocular; Treatment Outcome

The efficacy of dorzolamide/timolol fixed combination (DTFC) versus latanoprost/timolol fixed combination (LTFC) in open-angle glaucoma or ocular hypertensive patients.. Patients were randomized to DTFC or LTFC for 6 weeks and switched to opposite treatment for Period 2.. Thirty-two completed patients had a mean diurnal IOP of 19.5+/-3.2 mmHg for DTFC and 18.9+/-3.4 mmHg for LTFC (p=0.12), with no significant difference found between DTFC and LTFC at any timepoint following a Bonferroni correction (p>or=0.01).. Patients treated with DTFC and LTFC have a statistically similar ocular hypotensive effect.

Topics: Antihypertensive Agents; Cross-Over Studies; Double-Blind Method; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Prospective Studies; Prostaglandins F, Synthetic; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular

To determine the intraocular pressure (IOP)-lowering effect of a fixed timolol/dorzolamide combination (Cosopt) for patients with IOP over 30 mm Hg.. Prospective interventional case series.. Eighteen patients being seen on the Wills Eye Hospital Glaucoma Service with at least one eye with an IOP > 30 mm Hg were recruited. None had used any glaucoma medications for at least 1 month. IOP was confirmed by diurnal testing. Cosopt was administered at 9 am and 9 pm. Trough IOP measurements were made at 9 am and peak IOP measurements at 11 am at baseline, 1 month, and 2 months. Pretreatment and posttreatment IOPs were compared using a paired-samples independent t test.. Mean pretreatment IOP was 37.5 +/- 1.0 mm Hg. Baseline posttreatment IOP was 18.4 +/- 0.5 mm Hg (P < 0.01). At 2 months, the mean trough IOP was 21.1 +/- 0.9 mm Hg and the peak, 17.6 +/- 0.6 mm Hg (each, P < 0.01, as compared with pretreatment baseline IOP). One patient did not respond to Cosopt; two had a clinically insufficient response and did not complete the study. Data from these patients were included in the analysis.. Over 80% of the eyes responded to Cosopt, with an average trough IOP reduction of 40% at 2 months.

Topics: Adult; Antihypertensive Agents; Circadian Rhythm; Drug Combinations; Drug Therapy, Combination; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Prospective Studies; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular

To compare the efficacy of the fixed dorzolamide 2%/timolol 0.5% combination (COSOPT) versus latanoprost 0.005% (XALATAN).. Two 3-month, parallel group, randomized, observer-masked and patient-masked, multicentre, clinical trials were performed in patients with ocular hypertension or open-angle glaucoma. Study 1 (n=256) was conducted in the United States and Study 2 (n=288) was conducted in Europe/Israel. Patients could be included whether or not they were currently taking ocular hypotensive therapy, and regardless of the effectiveness of any previous therapy. Patients were washed out from their usual ocular hypotensive medications and then those with a baseline intraocular pressure (IOP) >/= 24 mmHg were randomized to either the dorzolamide/timolol combination eye drops twice daily or latanoprost eye drops once daily in both eyes. Efficacy was assessed by daytime diurnal IOP (the mean of measurements made at 0800, 1000, 1400 and 1600 h).. At baseline, the mean daytime diurnal IOP was 26.1 mmHg in the dorzolamide/timolol combination group versus 25.6 mmHg in the latanoprost group in Study 1, and 25.3 mmHg in the dorzolamide/timolol combination group versus 24.7 mmHg in the latanoprost group in Study 2. After 3 months, the mean daytime diurnal IOP was 18.9 mmHg for the dorzolamide/timolol combination versus 18.4 mmHg for latanoprost in Study 1, and 17.4 mmHg for the dorzolamide/timolol combination versus 17.5 for latanoprost in Study 2. The difference between treatments in mean IOP change at 3 months was -0.04 mmHg [95% confidence interval (CI) -0.85, 0.77] in Study 1, and -0.57 mmHg (95% CI -1.31, 0.16) in Study 2. The probability that the true difference lay between -1.5 and 1.5 mmHg, the predefined bounds for equivalence, was >0.950 in both studies. Both treatments were well tolerated over 3 months, although ocular stinging occurred more frequently with the dorzolamide/timolol combination.. The dorzolamide/timolol combination and latanoprost were equally effective at lowering IOP.

Topics: Antihypertensive Agents; Double-Blind Method; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Prostaglandins F, Synthetic; Safety; Sulfonamides; Thiophenes; Timolol; Treatment Outcome

We sought to compare the efficacy as well as the safety of two maximum medical therapy combinations applied to lower the intraocular pressure (IOP) in different primary open-angle glaucoma (POAG) age groups.. This was a retrospective, consecutive case series study that included 60 eyes of 60 subjects with POAG, specifically 20 subjects aged 40 to 54 years, 21 aged 55 to 69 years, and 19 aged 70 years or older. All had been treated for at least 12 months with triple maximum medical therapy (TMT; dorzolamide/timolol, brimonidine, and latanoprost) to lower their IOP, which subsequently was changed to double maximum medical therapy (DMT, fixed drug combinations of tafluprost/timolol and brinzolamide/brimonidine). The rate of IOP change and adverse drug reactions were compared amongst the three age groups.. The mean IOP change at three months after converting from TMT to DMT was -0.65 ± 1.42 mmHg (-3.84% ± 9.31%) among the overall study group, but this finding was not statistically significant (. In POAG patients, DMT was proven to be both effective and safe for lowering the IOP, especially in those 70 years or older group, when compared with the TMT protocol.

Topics: Adult; Aged; Antihypertensive Agents; Brimonidine Tartrate; Drug Combinations; Drug Therapy, Combination; Female; Follow-Up Studies; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Retrospective Studies; Sulfonamides; Thiophenes; Timolol; Treatment Outcome

Primary open-angle glaucoma (POAG) is a very common disorder, and it is the second leading cause that results in blindness worldwide after cataracts. Previous studies have reported that dorzolamide/timolol-fixed combination (DTFC) can be used in treating POAG. However, there are still inconsistent results. Thus, this study will systematically investigate the efficacy and safety of DTFC on POAG.. A comprehensive search will be carried out in Cochrane Library, MEDLINE, EMBASE, CINAHI, ACMD, China National Knowledge Infrastructure, and WANGFANG database from origin to the present. There are no limitations related to the language and publication status. Only randomized controlled trials that assessed the efficacy and safety of DTFC for the treatment of POAG will be included. Two researchers will independently undertake record selection, data extraction, and study quality assessment. Any divisions will be solved by discussion with a third researcher. We will perform statistical analysis using RevMan 5.3 software RESULTS:: This study will summarize the present evidence to identify the efficacy and safety of DTFC in treating POAG through mean intraocular pressure, best corrected visual acuity, contrast sensitivity, bioelectric activity of the retina, rate of progression of glaucoma, quality of life, and adverse events.. The results of this study will provide evidence of DTFC for the treatment of POAG.. INPLASY202040120.

Topics: Adrenergic beta-Antagonists; Carbonic Anhydrase Inhibitors; Drug Combinations; Glaucoma, Open-Angle; Humans; Meta-Analysis as Topic; Randomized Controlled Trials as Topic; Research Design; Sulfonamides; Systematic Reviews as Topic; Thiophenes; Timolol

To determine whether the consumption of topical glaucoma medication is influenced by the type of eye drop dispenser.. Retrospective cohort study.. We examined 366 patients with open-angle glaucoma or ocular hypertension who were bilaterally treated with 0.0015% tafluprost or 2% dorzolamide/0.5% timolol fixed combination (DTFC). The patients were grouped by the type of dispenser and content of eye drops used: (1) tafluprost in bottles (T-Bottle group); (2) tafluprost in unit-dose pipettes (T-Unit group); (3) DTFC in bottles (C-Bottle group); and (4) DTFC in unit-dose pipettes (C-Unit group). We evaluated the medication possession ratio (MPR) among groups, and factors associated with over-consumption (MPR > 1.2) or under-consumption (MPR < 0.8) in multinomial logistic regression.. The mean MPR was 1.49 (range, 0.69-2.91) in the T-Bottle group, 0.91 (range, 0.32-1.27) in the T-Unit group, 1.25 (range, 0.51-2.60) in the C-Bottle group, and 0.96 (range, 0.36-1.60) in the C-Unit group. The Bottle groups demonstrated higher mean values and wider ranges of MPR compared to the Unit groups. The MPR interval at which the largest number of patients were found was 1.0-1.4 in the Bottle groups and 0.8-1.2 in the Unit groups. Bottle-type dispenser (odds ratio [OR] 64.02), tafluprost medication (OR 2.84), and older age (OR 1.03) were associated with over-consumption, whereas no factor was correlated with under-consumption.. The type of eye drop dispenser affects the consumption of glaucoma medication. Physicians should consider the type of eye drop dispenser when assessing glaucoma medication adherence.

Topics: Administration, Ophthalmic; Aged; Antihypertensive Agents; Drug Combinations; Drug Packaging; Drug Utilization; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Prostaglandins F; Retrospective Studies; Sulfonamides; Thiophenes; Timolol

To compare the ocular pulse amplitude (OPA) lowering effects of preservative-free tafluprost and dorzolamide-timolol fixed combination (DTFC) using dynamic contour tonometry.. In total, 66 eyes of 66 patients with normal tension glaucoma (NTG) (n = 34) or primary open angle glaucoma (POAG) (n = 32) were included. Patients were divided into two groups: the preservative-free tafluprost-treated group (n = 33) and the preservative-free DTFC-treated group (n = 33). Intraocular pressure (IOP) was measured using Goldmann applanation tonometry (GAT). OPA was measured using dynamic contour tonometry; corrected OPA (cOPA) was calculated at baseline and at 1 week and 1, 3, and 6 months after treatment.. After 6 months of treatment, tafluprost significantly reduced IOP (P < 0.001). The OPA lowering effects differed significantly between the two treatment groups (P = 0.003). The cOPA-lowering effect of tafluprost (1.09 mmHg) was significantly greater than that of DTFC (0.36 mmHg) after 6 months of treatment (P = 0.01).. Tafluprost and DTFC glaucoma treatments provided marked OPA and IOP lowering effects. Tafluprost had a greater effect than DTFC; thus, this drug is recommended for patients at risk of glaucoma progression, due to the high OPA caused by large fluctuations in IOP.

Topics: Drug Combinations; Eye; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Low Tension Glaucoma; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Preservatives, Pharmaceutical; Prostaglandins F; Retrospective Studies; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular

To assess a change in visual-related quality of life (QoL) in glaucoma patients after switching from preservative-containing medical therapy to preservative-free unit dose timolol/dorzolamide fixed combination (TDFC UD).. Prospective, noninterventional, multicenter 8-week study. Primary outcome was a change in visual symptoms at week 8, as assessed by the Glaucoma Symptom Scale (GSS).. 80 patients completed the study. There was a clinically significant increase in the scores of all GSS-related categories at week 8 when compared to baseline (GSS symptom week 8: +21.15 ± 37.9%, GSS function week 8: +10.3 ± 31.6%, both p < 0.001 vs. baseline). Comparison between patients taking only TDFC UD and patients taking TDFC UD plus concomitant medications did not detect differences in any GSS category (p > 0.50 in all comparisons).. Switching to TDFC UD significantly improved the self-reported QoL of glaucoma patients. This can be seen even in patients who are taking concomitant ocular treatments.

Topics: Aged; Aged, 80 and over; Antihypertensive Agents; Drug Combinations; Drug Substitution; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Preservatives, Pharmaceutical; Prospective Studies; Quality of Life; Sickness Impact Profile; Sulfonamides; Surveys and Questionnaires; Thiophenes; Timolol; Visual Acuity

The purpose of this study was to compare the efficacy of selective laser trabeculoplasty (SLT) in eyes of patients with open-angle glaucoma receiving either a prostaglandin (PG) analog or a timolol/dorzolamide fixed combination (TDFC).. In this retrospective study, we analyzed 48 eyes of 35 patients who underwent SLT for open-angle glaucoma receiving either a PG analog (n=20) or a TDFC (n=28). Mean decrease in intraocular pressure (IOP) and success rates were compared between patients treated with PG and those treated with TDFC. Success was defined as an IOP reduction of at least 20% at postoperative 1 year.. The mean decrease in IOP in eyes treated with PG and in eyes treated with TDFC were 4.1±3.1 and 4.6±3.5 at 1 week (P=0.579), 5.3±3.4 and 5.7±2.0 at 1 month (P=0.485), 5.2±3.1 and 5.5±2.5 at 3 months (P=0.271), 5.0±3.1 and 6.1±2.5 and at 6 months (P=0.044), and 4.7±3.1 and 6.5±2.9 at 1 year (P=0.017), respectively. The success rate at postoperative 1 year was 50.0% (standard deviation±16) in eyes receiving PG and 78.6% (standard deviation:±11) in eyes receiving TDFC (P=0.041).. This study shows that the SLT seems to be more effective in TDFC users than PG analog users.

Topics: Aged; Antihypertensive Agents; Drug Combinations; Female; Follow-Up Studies; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Laser Therapy; Male; Middle Aged; Prostaglandins, Synthetic; Retrospective Studies; Sulfonamides; Thiophenes; Timolol; Trabeculectomy; Treatment Outcome

The aim of this study was to assess the effectiveness of dorzolamide-timolol (DT) in the management of open-angle glaucoma (OAG) and ocular hypertension.. An open-label, 12-week, multicenter, Canadian study was conducted. Patients with untreated OAG or ocular hypertension received DT for 12 weeks to reduce intraocular pressure (IOP). If target IOP was not reached after the first 6-week treatment period, a prostaglandin (PG) (latanoprost) was added for the remaining 6 weeks. Primary outcome measures were changes in IOP from baseline to 6 and 12 weeks of treatment, and secondary outcome measures included the proportion of patients achieving target IOP and the proportion of patients achieving therapeutic response defined as a reduction of 5.0 mmHg or 20% in IOP from baseline. IOP values were the mean of 2 measures taken before and at least 2 h after patients administered the study medication.. A total of 164 patients were enrolled. Mean [standard deviation (SD)] population age was 63.0 (12.3) years and 53.0% of the patients were men. At week 6, the mean (SD) absolute and percent change in IOP for the total population was (-11.1) (4.9) and (-36.4)% (13.9%), respectively, and 92.1% of the patients achieved a reduction in IOP of at least 5 mmHg. Therapeutic target was achieved by 136 (82.9%) patients (DT subgroup) at 6 weeks, whereas 28 (17.1%) patients were changed to a combination therapy of DT and latanoprost [DT plus PG (DT & PG) subgroup]. Between weeks 6 and 12, DT was effective in sustaining the IOP within therapeutic target, whereas addition of latanoprost reduced the IOP of the DT & PG subgroup by an additional 6.3 mmHg or 22.1% (20.1%). At week 12, patients in the DT subgroup experienced a clinically and statistically significant mean (SD) decrease in IOP from a baseline of 12.2 mmHg or 40.4% (11.9%) (P < 0.001), whereas these values corresponded to 13.4 mmHg and 39.7% (15.7%) (P < 0.001), respectively, in the DT & PG subgroup. The proportion of patients who achieved therapeutic response during the entire 12-week study period was over 82%. Treatment-related adverse events (AEs) were reported by 19 (14.0%) patients in the DT subgroup and by 6 (21.4%) patients in the combination subgroup. Eye disorders and nervous system disorders were among the most common treatment-related AEs in both subgroups. No serious AEs were reported during the study period.. DT alone and DT in combination with a PG are effective in significantly reducing IOP in patients with untreated OAG or ocular hypertension. The treatment was safe and well tolerated with a low incidence of AEs.

Topics: Aged; Drug Combinations; Eye; Female; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Multicenter Studies as Topic; Ocular Hypertension; Ophthalmic Solutions; Prostaglandins F, Synthetic; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular; Treatment Outcome

To evaluate the efficacy and tolerability of preservative-free eye drops (dorzolamide/timolol) in routine management of preservative-sensitive glaucoma patients.. Data from 2,298 glaucoma patients requiring intraocular pressure (IOP) reduction and suffering from intolerance to benzalkonium chloride or active agents of previously used eye drops were valid for baseline and safety analysis in this prospective, open, noncomparative, multicenter, noninterventional study. Patients were treated with preservative-free dorzolamide/timolol eye drops for 12 weeks. Main efficacy endpoint was IOP reduction after 12 weeks of treatment. Two thousand forty-nine patients were considered for efficacy analysis. Tolerability was assessed by evaluating adverse drug reactions.. Mean baseline IOP was 20.8 mmHg. Baseline IOP was reduced to 16.7 mmHg after 12 weeks of treatment corresponding to a mean absolute (percent) change of -4.1 mmHg (-17.3%). The proportion of patients with IOP ≤21 mmHg increased from 59.9% at baseline to 94.6% after 12 weeks. The most frequently reported ocular adverse drug reactions were burning eyes (2.4%) and hyperemia (0.9%). Local tolerability improved in 79.3% of patients compared to their previous glaucoma therapy.. This observational study confirms the IOP lowering effect of preservative-free eye drops containing the fixed combination of dorzolamide/timolol in a large patient's population. The drug was well tolerated and improved the local tolerability in the vast majority of patients.

Topics: Administration, Topical; Aged; Antihypertensive Agents; Benzalkonium Compounds; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Hyperemia; Intraocular Pressure; Male; Ophthalmic Solutions; Preservatives, Pharmaceutical; Prospective Studies; Sulfonamides; Thiophenes; Timolol; Treatment Outcome

To describe prescription trends within a managed care setting for glaucoma medications and to examine the effect of introduction of Cosopt--a fixed combination of dorzolamide and timolol.. All prescriptions dispensed to any of the 470,350 members of an Israeli health maintenance organization were monthly scanned for patients treated for glaucoma, between January 2000 and May 2003. The monthly mean number of glaucoma patients was 3899 +/- 104 (mean +/- SD). All topical glaucoma prescriptions were documented, and the monthly prescription rate of each medication was calculated and plotted. The monitored glaucoma medications were: beta-adrenergic antagonists, dorzolamide, latanoprost, pilocarpine, brimonidine, Cosopt, and others.. beta-adrenergic antagonists were the top prescribing drug (>35% of all glaucoma prescriptions). The prescription rates of pilocarpine and beta-adrenergic antagonists were in constant decline, while latanoprost and brimonidine increased steadily. The introduction of Cosopt changed the prescription trends of dorzolamide from increasing to rapidly decreasing, and accelerated the long-term decline of beta-adrenergic antagonists. Concomitant with the introduction of Cosopt the prescription rate of beta-adrenergic antagonists temporarily increased. This was due to a total increase in glaucoma prescriptions. When Cosopt was introduced, 37.5% of patients were prescribed Cosopt together with beta-adrenergic antagonists, and 16.5% also received dorzolamide. Thereafter the co-prescription decreased steadily.. Introduction of a combination drug should be accompanied by physicians', pharmacists', and patients' education to prevent its inappropriate usage together with its components.

Topics: Antihypertensive Agents; Drug Combinations; Drug Prescriptions; Drug Utilization; Glaucoma, Open-Angle; Health Maintenance Organizations; Health Services Research; Health Surveys; Humans; Intraocular Pressure; Israel; Ocular Hypertension; Practice Patterns, Physicians'; Sulfonamides; Thiophenes; Timolol

To study the intraocular pressure (IOP)-lowering effect of adding a third or a fourth antiglaucoma medication to preexisting antiglaucoma medical therapy, for a follow-up period of one year.. The authors performed a retrospective, nonrandomized, noncomparative, interventional study including all patients seen by a single glaucoma specialist at the University of Florida Eye Clinic between January 1, 2000 and December 31, 2000, who had a third or a fourth antiglaucoma medication added to their existing regimen of two or three antiglaucoma medications, respectively. The main outcome measured was IOP at 2, 6, 9, and 12 months after addition of an antiglaucoma medication. "Efficacy" success was defined as a decrease in intraocular pressure of greater than or equal to 20% from baseline, without a change in the antiglaucoma medical therapy. Also, "safety outcome" was analyzed based on the need for surgical intervention and/or the occurrence of intolerable side effects to the antiglaucoma medications leading to discontinuation of their use.. Sixty-seven patients had a third, and 29 patients had a fourth antiglaucoma medication added to their existing regimen. Analysis for a specific time point showed a success rate of 48% at 2 months (n = 65), 47% at 6 months (n = 47), and 41% at 1 year (n = 39) after addition of a third antiglaucoma medication and 59% at 2 months (n = 29), 45% at 6 months (n = 22), and 55% at 1 year (n = 20) after addition of a fourth antiglaucoma medication. By Kaplan-Meier analysis the cumulative probability of achieving efficacy success (> or = 20% IOP decrease from baseline) was 33% at 6 months and 23% at 1 year after adding a third medication (Group A), and 43% at 6 months and 18% at 1 year after adding a fourth medication (Group B). Combining both efficacy and safety outcomes decreased the cumulative probability of success to 27% and 14% in Group A, and 31% and 14% for Group B, at 6 months and 1 year respectively.. Addition of a third and fourth antiglaucoma medication produces a clinically significant reduction in IOP in about 40 to 60% of patients at any single time point. However, the cumulative probability of success including safety outcomes is relatively poor at 6 months and 1 year. This suggests that adding another antiglaucoma medication to a regimen of two or three medications frequently does not achieve a significant (> or = 20%) fall in IOP.

Topics: Adrenergic alpha-Agonists; Adrenergic beta-Antagonists; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Drug Combinations; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Pilocarpine; Prostaglandins; Retrospective Studies; Safety; Sulfonamides; Thiophenes; Timolol; Treatment Outcome

Topics: Antihypertensive Agents; Computer Graphics; Corneal Topography; Diagnosis, Differential; Drug Combinations; Drug Therapy, Combination; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Manometry; Middle Aged; Optic Disk; Prostaglandins F, Synthetic; Signal Processing, Computer-Assisted; Sulfonamides; Thiophenes; Timolol; Visual Fields