Travoprost Plus Timolol Offers Improved Lowering of Intraocular Pressure Compared With Travoprost Alone: Presented at ARVO

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Title: Travoprost Plus Timolol Offers Improved Lowering of Intraocular Pressure Compared With Travoprost Alone: Presented at ARVO
URL: http://www.pslgroup.com/dg/2206FE.htm
Doctor's Guide
April 30, 2008

By Cameron Johnston

FORT LAUDERDALE, Fla -- April 30, 2008 -- European patients with glaucoma who are being treated with the fixed-dose combination of travoprost plus timolol may achieve better intraocular pressure (IOP) compared with those who use travoprost alone.

The findings were presented here on April 29 at the Association for Research in Vision and Ophthalmology (ARVO) 2008 Annual Meeting.

In a study conducted in Greece of 34 patients, each of the treatments was dosed in the evening. Both provided reductions in IOP that were statistically significant from baseline, but patients using the fixed-dose combination had lower absolute reductions in IOP and also had lower 24-hour fluctuations. All patients in this study had primary open-angle glaucoma.

Daily fluctuations are believed to have as much if not more effect on glaucomatous damage to the optic nerve as the elevated IOP does in the first place. Subjects using the fixed-dose combination experienced a mean fluctuation range of 3.0 mmHg while the mean fluctuation range when using travoprost alone was 4.0 mmHg.

The patients went through an initial 6-week washout period during, followed by two 8-week periods where they were given the fixed-dose combination for the first 8 weeks, then were switched to travoprost alone for the second 8-week period.

At the end of the initial washout, and again at the end of the study, patients had their IOP tested every 3 hours over a 24-hour period to establish a complete around-the-clock record of fluctuations in IOP. Thirty-two of the 34 patients completed the study.

The greatest reductions in IOP between the 2 treatment groups were seen at the 10:00 AM reading, when those using travoprost plus timolol had a mean reduction of 11.3 mm Hg from baseline, while the patients who were using the travoprost alone had a mean reduction of 8.7 mm Hg. Throughout the day, the differences in IOP ranged from approximately 1.5 mm Hg to 2.3 mm Hg between the 2 groups.

There was no difference in the rate of adverse events between the groups, although such events were not uncommon. Stinging, for example was reported by 14.7% of patients using the fixed-dose combination compared with 11.8% of patients using travoprost alone. Ocular hyperaemia was seen in 15.0% of those using the fixed-dose combination compared with 24.0% of patients using travoprost alone. Foreign-body sensation was not seen in any patients using the fixed dose-combination, but was seen in approximately 8.0% of patients using travoprost alone.

The mean minimum IOP achieved overall was 15.7 mmHg when the patients were using the fixed-dose combination, compared with 17.7 mmHg when they were using travoprost alone.

These data confirm that the fixed-dose combination of travoprost and timolol offers better IOP lowering on a number of parameters compared with travoprost alone, said coinvestigator Anastasios Konstas, MD, PhD, Professor of Ophthalmology, University General Hospital of Thessaloniki, Thessaloniki, Greece.

Further studies are needed to determine whether evening or morning dosing is superior.

The fixed-dose combination is not available in the United States.

Presentation title: 24-Hour Intraocular Pressure Control With the Travoprost/Timolol Fixed Combination Compared With Travoprost When Both Are Dosed in the Evening in Primary Open-Angle Glaucoma. Abstract A54]

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