EFFICACY AND SAFETY OF BRIMONIDINE, DORZOLAMIDE AND LATANOPROST AS ADJUNCTIVE THERAPY IN PRIMARY OPEN ANGLE GLAUCOMA

Abstract

SUMMARYA double‐blind, randomised, controlled trial was carried out to evaluate the efficacy and safety of brimonidine, dorzolamide and latanoprost as an adjunctive therapy in patients with primary open angle glaucoma (POAG). A total of 200 males and 72 females with POAG uncontrolled with previous glaucoma therapy were randomly allocated to receive topical brimonidine 0.2% b.d. (n=90), topical dorzolamide 2% b.d. (n=91) or topical latanoprost 0.005% o.d. (n=91). One year post treatment, the mean percentage reduction in intraocular pressure (IOP) between the three groups was statistically significant (p<0.0001). In an intergroup comparison of efficacy, there was a statistically significant difference between the brimonidine and dorzolamide groups (p=0.018) and between the dorzolamide and latanoprost groups (p=0.76) but the efficacy of brimonidine was not significantly higher than latanoprost in the brimonidine and latanoprost groups (p=0.002). Patients experiencing mild to severe side‐effects were statistically similar in the three groups. On an inter‐drug comparison of side‐effects, we found no statistically significant difference in the brimonidine and latanoprost groups (p=0.25); and the brimonidine and dorzolamide groups (p=0.067), while the number of side‐effects with latanoprost was significantly higher in the dorzolamide and latanoprost groups (p<0.003). All three drugs caused a significant reduction in the mean IOP from pretreatment values. The brimonidine group had a higher number of patients experiencing severe side‐effects necessitating alteration of therapy.