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Two Prostaglandins Largely Similar in Intraocular Pressure Reduction for Glaucoma Patients: Presented at ARVO

By Earl R. Nichols

FT. LAUDERDALE, FL -- May 9, 2005 -- Two prostaglandin analogues -- bimatoprost (Lumigan) and travoprost (Travatan) -- have similar efficacy when used in treating patients with open angle glaucoma or ocular hypertension.

The only difference between the two agents in terms of reducing intraocular pressure (IOP) is minor and though perhaps statistically significant, it is probably not clinically meaningful, according to Louis Cantor, MD, professor and director of glaucoma services, Indiana University School of Medicine, Indianapolis, Indiana, United States.

Dr. Cantor and colleagues studied 77 patients who used bimatoprost and had a mean IOP at 9:00 AM that was 1.8 mm Hg lower than what was seen among 81 patients using travoprost. He presented the findings during a poster session here at the Association for Research in Vision and Ophthalmology Annual Meeting.

Mean IOP reductions at 9:00 AM were 7.1 to 8.2 mm Hg from baseline in the bimatoprost group and 5.6 to 6.4 mm Hg from baseline in the travoprost group.

The difference in IOP reductions at the 1:00 PM and 4:00 PM time points also favoured the bimatoprost group, but these differences were not statistically significant, Dr. Cantor said. The mean IOP among bimatoprost-treated patients was 22.0 mm Hg at 4:00 PM and 22.2 mm Hg in the travoprost-treated patients.

By the end of 6 months of follow-up the mean IOP ranged from 16.5 to 17.5 mm Hg in the bimatoprost-treated group and from 17.3 to 18.6 mm Hg in the travoprost-treated group.

According to the American Academy of Ophthalmology preferred practice guidelines, the goal is to reduce IOP by a range of 30%.

The differences seen in this study were too small and inconsistent to say conclusively that one medication was superior to the other, according to the researchers. The difference in IOP reduction between the two agents was 1.8 mm Hg at one time-point while the differences were not significant during the rest of the day. However, 63.4% of patients using bimatoprost and 36.6% of those using travoprost achieved a reduction in IOP of at least 25%.

An important point to consider, Dr. Cantor said, is that it is not only the lowering of the IOP itself that is important, but also to flatten out the peaks and valleys that are seen throughout the day.

As for adverse effects seen with the two agents, four patients withdrew from the travoprost arm in this study due to lack of efficacy and four withdrew due to redness, itching of the eyes and allergic reactions.


[Presentation title: IOP-Lowering Efficacy of Bimatoprost 0.03% and Travoprost 0.004% in Patients With Glaucoma or Ocular Hypertension. Poster 2451/B4]

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