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Comparison of Intraocular Pressure-Lowering Effects of Latanoprost and Bimatoprost: Presented at ARVO
By Earl R. Nichols
FT. LAUDERDALE, FL -- May 5, 2005 -- A novel study among glaucoma patients has shown that patients may have different responses to drugs that lower intraocular pressure (IOP) when those drugs are used in opposite eyes - even when used at the same time.
A further finding of the research, presented here May 3rd at Association for Research in Vision and Ophthalmology Annual Meeting was that the eyes do not function in tandem, but each eye may respond differently to a particular medication.
The study involved a cohort of 83 glaucoma patients who were treated in one eye with bimatoprost 0.03% daily while in the other eye they were treated with latanoprost 0.005% daily.
This appears to challenge the belief that both eyes respond in concert to any specific drug -- i.e., that if bimatoprost is used in one eye, the second eye would respond with a similar reduction in intraocular pressure.
Dr. Robert Noecker, professor of ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States, led a team of researchers who evaluated IOP at baseline and again at 1 and 2 months post-treatment.
The researchers found that after 1 month of treatment, IOP decreased by 26.4% in the latanoprost-treated eye, compared with a decrease of 31.5% from baseline in the bimatoprost-treated eye. This 1.3 mmHg difference was statistically significant (P <.001)
The reductions in IOP after 2 months of treatment also favoured the bimatoprost eye (28.5% vs. 23.4%). This difference was also significant P <.001.
Adverse events, especially conjunctival hyperemia, were more common in the bimatoprost-treated eyes compared to the eyes treated with latanoprost (25% vs. 15%).
Dr. Noecker said this proves what has been suspected for some time; that patients do not respond to all drugs in the same way. For example, almost 60% of patients using bimatoprost had a positive response to therapy compared with 23% of those using latanoprost.
A positive response was defined as a decrease in IOP of at least 20% from baseline. In fact, he added, 16% of patients responded equally well to either drug.
While the difference in responses was small (1.3 mmHg), this could represent an important advantage. A previous well-known study of glaucoma concluded that for every 1 mmHg reduction in IOP, the risk of progressing to glaucomatous damage of the optic nerve is reduced by 10%
[Presentation title: Evaluation of Bimatoprost 0.03% versus Latanoprost 0.005%: A Paired Comparison Study. Poster 2452/B5]
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