Comparison of the Effects of Latanoprost, Travoprost, and Bimatoprost on Circadian Intraocular Pressure in Patients with Glaucoma or Ocular Hypertension

doi:10.1016/j.ophtha.2005.10.045

Ophthalmology

Volume 113, Issue 2, February 2006, Pages 239-246

https://doi.org/10.1016/j.ophtha.2005.10.045 Get rights and content

Purpose

To compare 24-hour reduction in intraocular pressure (IOP) by latanoprost 0.005%, travoprost 0.004%, and bimatoprost 0.03% in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH).

Design

Randomized, double-masked, crossover study.

Participants

Twenty-four patients with POAG and 20 with OH.

Methods

Patients were treated with latanoprost, travoprost, and bimatoprost for 1 month. The treatment sequence was randomized, and washout lasted 30 days for each trial drug. Four 24-hour tonometric curves were recorded for each patient: 1 at baseline and 1 after each treatment period.

Main Outcome Measures

Intraocular pressure was measured at 3, 6, and 9 am; noon; 3, 6, and 9 pm; and midnight by 2 treatment-masked well-trained evaluators using a handheld electronic tonometer with the patient in supine and sitting positions and a Goldmann applanation tonometer with the patient sitting at the slit lamp. Supine systemic blood pressure was recorded at the same times. A randomized-blocks analysis of variance was used to analyze data.

Results

All 3 drugs were highly effective in reducing IOP when compared to baseline. Mean IOP reductions were similar after the 3 prostaglandin analogs, and none of the differences among treatments reached statistical significance. The drugs’ effect was significantly greater during the daytime (9 am–9 pm) than during the nighttime (midnight–6 am) with all prostaglandin analogs. In 7 of 44 patients (16%), nocturnal IOP was significantly higher than diurnal IOP, both at baseline and under the 3 prostaglandin analogs.

Conclusions

From a clinical point of view, the overall results seem to indicate that the 3 prostaglandin analogs are powerful agents in controlling round-the-clock IOP in POAG and OH patients.

Section snippets

Materials and Methods

The method used to evaluate the 24-hour curves is described in detail in our previous articles.28, 33 A summary of the procedures follows. This study was carried out on patients diagnosed as having POAG or OH. To be included, glaucoma patients had to have an IOP of >21 mmHg without medication (in at least one eye and measured on 2 consecutive occasions separated by an interval of at least 2 hours but not more than 12 weeks), glaucomatous field (on the basis of at least 2 reliable Humphrey 30-2

Results

Forty-four patients were included in the trial. Their main characteristics are shown in Table 1. All patients completed the 3 crossover phases, and no major adverse event was recorded.

Figure 1 shows the circadian Goldmann tonometer IOP curves recorded at baseline and after latanoprost, travoprost, and bimatoprost treatment: all of the drugs significantly reduced IOP at all time points. The mean (± SD) IOP values were 21.9±3.4 mmHg at baseline, 16.2±3.2 on latanoprost, 15.9±3.1 on travoprost,

Discussion

The results of this crossover trial clearly indicate that all 3 of the prostaglandin analogs are very effective in reducing IOP in comparison with baseline, thus confirming the findings of previous studies.7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 40 The level of IOP obtained with the 3 drugs was fairly stable throughout the 24 hours, though the drugs’ effect was greater during the daytime hours, when baseline IOP was significantly higher. Mean IOP-lowering

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Cited by (111)

Single Administration of Bimatoprost Implant: Effects on 24-Hour Intraocular Pressure and 1-Year Outcomes
2023, Ophthalmology Glaucoma
To evaluate the effects of a single bimatoprost implant administration on 24-hour intraocular pressure (IOP) lowering at 8 weeks, and 1-year IOP-lowering efficacy and safety outcomes.
Multicenter, open-label, 12-month, phase 3b study (NCT04285580).
Adults with open-angle glaucoma or ocular hypertension.
Participants (n = 31) received 10-μg bimatoprost implant in the study eye on day 1; IOP (sitting and/or supine) was measured with pneumatonometry every 2 hours throughout a 24-hour period at baseline and week 8. IOP was measured by Goldmann applanation tonometry (GAT) at hour 0 (8 am ± 1 hour) at baseline, weeks 8 and 16, and months 6, 9, and 12.
The primary endpoint was the week-8 hour-matched change from baseline in habitual position IOP over 24 hours assessed with pneumatonometry. Hour 0 IOP change from baseline measured with GAT in study eyes that received no additional (rescue) IOP-lowering treatment, treatment-emergent adverse events (TEAEs), and central corneal endothelial cell density (CECD) were evaluated through 12 months.
The mean (standard deviation [SD]) baseline IOP at hour 0 was 24.2 (2.70) mmHg and 25.3 (7.15) mmHg by GAT and pneumatonometry, respectively. Pneumatonometer measurements of IOP taken over 24 hours at week 8 with the participant in habitual position (sitting from 8 am to 10 pm, supine from 12 am to 6 am) showed consistent IOP lowering through the day and night and reduced fluctuation in IOP. The range in IOP measurements over 24 hours was reduced from baseline by a mean (SD) of −1.6 (2.98) mmHg. All 31 bimatoprost implant–treated participants completed the 12-month study; 23 (74%) required no rescue IOP-lowering treatment. The mean (SD) IOP reduction from baseline at month 12 in nonrescued eyes was −4.3 (3.35) mmHg. The most common TEAE was conjunctival hyperemia (incidence 35.5%, 11/31). No implant-treated eye had a ≥ 15% loss in CECD from baseline.
A single intracameral administration of the bimatoprost implant lowered IOP in the habitual position consistently throughout the day and night at week 8. The majority of participants continued to have reduced IOP for 1 year without additional therapy. The 1-year safety profile was favorable.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Bimatoprost loaded microemulsion laden contact lens to treat glaucoma
2019, Journal of Drug Delivery Science and Technology
Bimatoprost is widely used to manage glaucoma. Currently, it is delivered via eye drop solution in high doses due to poor ocular bioavailability. The high and daily ocular dosing lead to ocular hyperaemia causing patient non-compliance. The contact lenses can be used to sustain the release of drug by conventional soaking technology, without altering the critical contact lens properties. However, the soaking method showed low drug uptake and high burst release, due to the absence of efficient controlling membrane. Here we investigate the effect of microemulsion on bimatoprost uptake from the soaking solution and its effect on drug release kinetics. The contact lenses were soaked in bimatoprost-microemulsion soaking solution (ME) and compared with the bimatoprost-soaking solution (SM) without microemulsion. The uptake of bimatoprost-microemulsion in the contact lenses did not altered the swelling, transmittance and folding endurance properties. The two fold increase in the uptake/loading of bimatoprost was noted from the bimatoprost-microemulsion (ME) soaking solution in comparison to bimatoprost-soaking solution (SM). The in vitro flux data of ME batches (up to 48–96 h) showed improvement in the release rate profiles in comparison to SM batches (up to 24–36 h). The in vivo studies in the rabbit tear fluid showed low burst release and improvement in the bimatoprost retention time with ME contact lens in comparison to the SM contact lens and eye drop solution. The study demonstrate the potential of microemulsion to improve the uptake of bimatoprost and sustain release kinetics without altering the critical lens properties of the contact lens.
Prospective randomized clinical trial on the effects of latanoprost, travoprost and bimatoprost on latanoprost non-responders
2019, Journal Francais d'Ophtalmologie
To determine whether a patient who is non-responder to latanoprost after one month of use should continue using latanoprost or switch to either bimatoprost or travoprost.
Prospective randomized clinical trial. We recruited new patients who were felt to require intraocular pressure reduction. Patients who had ≤ 20% intraocular pressure reduction after one month of latanoprost treatment were randomly assigned to another month of treatment with latanoprost or a switch to bimatoprost or travoprost for an additional month.
Overall, 83 non-responders to latanoprost after one month of treatment were included in the study. Before latanoprost treatment, the mean intraocular pressure was 23.7 ± 4.7 mmHg. At randomization on latanoprost, mean intraocular pressure was 21.5 ± 4.5 mmHg. One month after the switch of medication, the mean reduction in intraocular pressure was not significantly different between the groups (P = 0.148) and was −0.9 mmHg, −2.10 mmHg and −2.5 mmHg, for latanoprost, bimatoprost and travoprost respectively. One month after randomization, 32 (38.5%) of the patients had become responders, with IOP reduction > 20%. Of those patients, 9 (31%) were using latanoprost, 13 (41.9%) bimatoprost and 10 (43.5%) travoprost. The number of new responders was similar between the three groups (P = 0.584).
There is no added benefit of switching latanoprost to another topical prostaglandin for patients who are initially non-responders. Regression towards the mean and the Hawthorne effect are probably important factors explaining the additional IOP reduction obtained after randomization and explain the result of most switch studies.
Nous voulions vérifier si les patients qui ne répondent pas au latanoprost après un mois d’utilisation, devraient continuer le latanoprost ou changer pour le bimatoprost ou le travoprost.
Étude randomisée et prospective. On a recruté des nouveaux patients qui nécessitaient une réduction de la pression intraoculaire. Ceux qui avaient une réduction de ≤ 20 % après un mois sur latanoprost ont été randomisés à continuer le latanoprost ou changer pour le bimatoprost ou le travoprost pour un autre mois.
Nous avons recruté 83 patients qui ne répondaient pas au latanoprost. Sans traitement, la pression intraoculaire moyenne était de 23,7 ± 4,7 mmHg. Avec le latanoprost, elle était 21,5 ± 4,5 mmHg. Un mois après le changement de molécules, on notait une baisse additionnelle de 0,9 mmHg pour le latanoprost, 2,1 mmHg pour le bimatoprost et 2,5 mmHg pour le travoprost. Il n’y avait pas de différence entre les groupes (p = 0,148). Un mois après la randomisation, 32 (38,5 %) patients avaient une réponse > 20 % dont 9 (31 %) pour le latanoprost, 13 (41,9 %) pour le bimatoprost et 10 (43,5 %) pour le travoprost. Il n’y avait pas de différence entre les groupes (p = 0,584).
Nous n’avons pas trouvé de bénéfice à changer de prostaglandine si la réponse initiale au latanoprost est insatisfaisante. La régression vers la moyenne et l’effet Hawthorne sont des facteurs importants pour expliquer la baisse additionnelle après la randomisation et expliquent en grande partie, les résultats des nombreuses études de changement de molécules.
24-h monitoring devices and nyctohemeral rhythms of intraocular pressure
2016, Progress in Retinal and Eye Research
Intraocular pressure (IOP) is not a fixed value and varies over both the short term and periods lasting several months or years. In particular, IOP is known to vary throughout the 24-h period of a day, defined as a nyctohemeral rhythm in humans. In clinical practice, it is crucial to evaluate the changes in IOP over 24 h in several situations, including the diagnosis of ocular hypertension and glaucoma (IOP is often higher at night) and to optimize the therapeutic management of glaucoma. Until recently, all evaluations of 24-h IOP rhythm were performed using repeated IOP measurements, requiring individuals to be awakened for nocturnal measurements. This method may be imperfect, because it is not physiologic and disturbs the sleep architecture, and also because it provides a limited number of time point measurements not sufficient to finely asses IOP changes. These limitations may have biased previous descriptions of physiological IOP rhythm. Recently, extraocular and intraocular devices integrating a pressure sensor for continuous IOP monitoring have been developed and are available for use in humans. The objective of this article is to present the contributions of these new 24-h monitoring devices for the study of the nyctohemeral rhythms. In healthy subjects and untreated glaucoma subjects, a nyctohemeral rhythm is consistently found and frequently characterized by a mean diurnal IOP lower than the mean nocturnal IOP, with a diurnal bathyphase – usually in the middle or at the end of the afternoon – and a nocturnal acrophase, usually in the middle or at the end of the night.
Efficacy of Latanoprostene Bunod 0.024% Compared With Timolol 0.5% in Lowering Intraocular Pressure Over 24 Hours
2016, American Journal of Ophthalmology
To compare the diurnal and nocturnal effects of latanoprostene bunod 0.024% solution with timolol maleate 0.5% solution on intraocular pressure (IOP) and ocular perfusion pressure.
Prospective, open-label randomized crossover trial.
Twenty-five patients (aged 43–82 years) with ocular hypertension or early primary open-angle glaucoma were enrolled. Baseline IOP and blood pressure were measured in a sleep laboratory every 2 hours in the sitting and supine positions during the 16-hour diurnal/wake period and in the supine position during the 8-hour nocturnal/sleep period. Subjects were randomly assigned to bilateral treatments of latanoprostene bunod at 8 PM or timolol at 8 AM and 8 PM. The second laboratory recording occurred after the 4-week treatment. Subjects were crossed over to the comparator treatment for 4 weeks before the third laboratory recording. Mean IOP and calculated ocular perfusion pressure were compared for the diurnal and nocturnal periods.
Twenty-one subjects completed the study. Both treatments reduced diurnal sitting and supine IOP compared to baseline by 2.3–3.9 mm Hg (all P < .001) with no statistically significant difference between the 2 treatments. Nocturnal IOP under latanoprostene bunod treatment was 2.5 ± 3.1 mm Hg (mean ± SD) less than baseline (P = .002) and 2.3 ± 3.0 mm Hg less than timolol treatment (P = .004). Latanoprostene bunod treatment resulted in greater diurnal sitting and supine ocular perfusion pressures compared with baseline (P ≤ .006) and greater nocturnal ocular perfusion pressure compared with timolol treatment (P = .010).
During the nocturnal period, latanoprostene bunod caused more IOP reduction and more increase of ocular perfusion pressure than timolol.
Twenty-four hour efficacy of glaucoma medications
2015, Progress in Brain Research
Current medical therapy of glaucoma aims to attain a meaningful and consistent reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which will commensurate with either stability, or delayed progression of visual loss. Glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous. Therefore, it is reasonable that we should endeavor to identify the true efficacy of currently available and future antiglaucoma medications throughout the 24-h period. This review chapter deals first with the concept and value of diurnal and 24-h pressure monitoring. It then evaluates existing evidence on the 24-h efficacy of medical therapy options. Unfortunately, significant gaps exist in our present understanding of the short-term and particularly the long-term 24-h efficacy of most antiglaucoma medications. More long-term controlled evidence is needed in the future to improve our understanding of the 24-h efficacy of current medical glaucoma therapy, the ideal 24-h target pressure and the precise impact of IOP characteristics upon the different stages of the various forms of glaucoma.

View all citing articles on Scopus

Manuscript no. 2005-163.

None of the authors has any proprietary interest in any of the drugs or instruments used in the trial.

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Original ArticleComparison of the Effects of Latanoprost, Travoprost, and Bimatoprost on Circadian Intraocular Pressure in Patients with Glaucoma or Ocular Hypertension

Purpose

Design

Participants

Methods

Main Outcome Measures

Results

Conclusions

Section snippets

Materials and Methods

Results

Discussion

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Original Article
Comparison of the Effects of Latanoprost, Travoprost, and Bimatoprost on Circadian Intraocular Pressure in Patients with Glaucoma or Ocular Hypertension