A randomized, investigator-masked comparison of diurnal responder rates with bimatoprost and latanoprost in the lowering of intraocular pressure

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Abstract

In glaucoma and ocular hypertension, clinically relevant intraocular pressure lowering due to a new medication is frequently defined as at least a 15% or 20% reduction from baseline intraocular pressure. This report compares the percentages of treated patients achieving such reductions in intraocular pressure after 6 months of treatment with bimatoprost or latanoprost. In the previously published study (Noecker et al: A six-month randomized clinical trial comparing the intraocular pressure-lowering efficacy of bimatoprost and latanoprost in patients with ocular hypertension or glaucoma. Am J Ophthalmol 135:55–63, 2003), patients with glaucoma or ocular hypertension were randomly assigned to once-daily treatment with bimatoprost 0.03% (n = 133) or latanoprost 0.005% (n = 136), after washout of any previous glaucoma medications. The primary outcome measure of that study was mean change from baseline intraocular pressure. The secondary, post hoc analysis presented here compares the diurnal and long-term responder rates observed with bimatoprost and latanoprost patients. Diurnal responders were defined as patients who achieved at least a 15% or 20% reduction from baseline intraocular pressure at each of the three timepoints (8 am, 12 pm, and 4 pm) on a given visit. At week 1 and months 1, 3, and 6, in the bimatoprost group, 70.7–81.2% of patients achieved at least a 15% reduction in IOP at each timepoint, and 57.9–68.4% achieved at least a 20% reduction. Significantly fewer patients receiving latanoprost achieved a 15% or a 20% decrease in IOP at each timepoint: 48.5–61.8% of patients achieved at least a 15% decrease and 36.0–47.1% achieved at least a 20% decrease. (P≤.007). The data presented here suggest that patients using bimatoprost are more likely than patients using latanoprost to achieve intraocular pressure reductions of at least 15% or 20% from baseline throughout the day.

Section snippets

Methods

The methods used in the 6-month comparison trial of bimatoprost and latanoprost were described in detail previously16 and are briefly summarized here.

Patient disposition and characteristics

A full description of the patient population has been published previously.16 In summary, of 320 patients who were screened, 51 (19%) did not meet the inclusion/exclusion criteria, and 269 were enrolled (n = 133 bimatoprost and n = 136 latanoprost). A total of 249 patients (92.6%) completed the study (bimatoprost, n = 124; latanoprost, n = 125). Patients ranged in age from 24–88 (mean 61.3) years and nearly two-thirds were women. Most patients were white (83%; 223/269), while 11% (29/269) were black

Discussion

This analysis of diurnal responder rates found that a significantly greater proportion of patients treated with bimatoprost than with latanoprost consistently showed a substantial, clinically relevant lowering of IOP, defined as a decrease of at least 15% or 20% from baseline throughout the day.

Diurnal responder rates may provide important, clinically relevant information about the clinical utility of a drug because studies have suggested that it is important to maintain consistent IOP control

Conclusion

This post hoc analysis of data from our previously published study offers further evidence that bimatoprost provides superior IOP control to latanoprost. Although the selection of any medication will, of course, take individual patient factors into account, results from such analyses may assist in guiding clinical practice by providing a strong evidence base for medication selection.

Method of literature search

A search of the Medline database was used to identify relevant papers published from 1990 through 2003. The search terms used were: latanoprost, bimatoprost, responder, glaucoma, and diurnal IOP. The most relevant references are cited in this article.

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  • Cited by (0)

    This study was sponsored by Allergan Inc. Paula Bernstein, MS, Scott Whitcup, MD, and Amy Batoosingh, BA, are employees of Allergan Inc.

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