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Bimatoprost, Timolol Compared For Glaucoma And Ocular Hypertension

Once daily bimatoprost appears to provide sustained lowering of intraocular pressure that is superior to timolol or bimatoprost twice daily.

Clinicians with the Bimatoprost Study Groups report two identical, multicentre, randomized, double-masked, 1-year clinical trials comparing bimatoprost once daily, bimatoprost twice daily, or timolol maleate.

One group of 474 patients was treated with 0.03% bimatoprost once daily, a second group of 483 patients was treated with 0.03% bimatoprost twice daily and a third group of 241 patients was treated with 0.5% timolol maleate twice daily.

The investigators measured diurnal intraocular pressure at 8 AM, 10 AM, and 4 PM, as well as safety variables. Intraocular pressure was also measured at 8 PM at selected sites.

Bimatoprost once daily provided significantly lower mean intraocular pressure than timolol at every time of the day at each study visit (P<.001). This was also true for bimatoprost twice daily at most time points, though the efficacy was not as good as that of the once daily regimen.

Even at the time that timolol had its peak effect (10 AM), at month 12 the mean reduction in intraocular pressure from baseline was 7.6 mm Hg (30 percent) with bimatoprost and 5.3 mm Hg (21 percent) with timolol (p<.001). Intraocular pressure at or below 17 mm HG was achieved by a significantly higher percentage of patients receiving bimatoprost once daily (58 percent) than timolol (37 percent; p<.001).

Hyperemia was the most common side effect associated with bimatoprost, and was significantly higher with the once daily regimen than timolol (p < .001).
Arch Ophthalmol. 2002;120:1286-1293. "One-Year, Randomized Study Comparing Bimatoprost and Timolol in Glaucoma and Ocular Hypertension"

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