ANNE S.LINDBLADPhDAuthor Affiliations: Morehouse School of Medicine and Emory University School of Medicine, Atlanta, Georgia (Dr Higginbotham); Maryville Eye Center, PC, Maryville, Tennessee (Dr Olander); and Pfizer Inc, New York, New York (Drs Kim, Grunden, and Tressler and Mr Kwok). Dr Higginbotham is now with the Office of the Senior Vice President for Health Sciences, Howard University, Washington, DC.
To assess the efficacy and safety of fixed-combination latanoprost-timolol (FCLT) vs latanoprost or timolol monotherapy.
This 12-week, randomized, double-masked, parallel-group study included patients with open-angle glaucoma or ocular hypertension treated with a β-blocker and with baseline intraocular pressure (IOP) of 26 through 36 mm Hg. Following washout, eligible patients were randomized to once-daily FCLT in the evening, latanoprost in the evening, or timolol in the morning.
Main Outcome Measures
Postbaseline IOP assessments at 8 AM, 10 AM, and 4 PM at weeks 2, 6, and 12; statistical superiority of FCLT for the 18 pairwise comparisons between FCLT and the 2 monotherapies, using analysis of variance.
All therapies resulted in significant IOP reductions from baseline. Pairwise comparisons favored FCLT at all time points. When the 18 comparisons were tested simultaneously, FCLT was statistically superior to latanoprost at 7 of 9 time points and at all 9 time points when compared with timolol. In addition, FCLT was associated with greater percentage reductions in diurnal IOP levels and a greater likelihood of achieving lower mean diurnal IOP levels. Diurnal IOP reductions of 30% or more from baseline to week 12 were achieved by 73.5%, 57.5%, and 32.8% of those treated with FCLT, latanoprost, and timolol, respectively (P = .007 for FCLT vs timolol; P < .001 for FCLT vs latanoprost). All therapies were well tolerated.
Fixed-combination latanoprost-timolol therapy is as safe and effective in lowering IOP in patients with either ocular hypertension or glaucoma as monotherapy with latanoprost or timolol. Combination therapy can be used to treat patients for whom monotherapy does not provide sufficient IOP reduction.
Application to Clinical Practice
The simplicity, efficacy, and tolerability of FCLT contribute to its utility in clinical practice.
clinicaltrials.gov Identifier NCT00277498
Higginbotham EJ, Olander KW, Kim EE, Grunden JW, Kwok KK, Tressler CS, United States Fixed-Combination Study Group. Fixed Combination of Latanoprost and Timolol vs Individual Components for Primary Open-Angle Glaucoma or Ocular HypertensionA Randomized, Double-Masked Study. Arch Ophthalmol. 2010;128(2):165-172. doi:10.1001/archophthalmol.2009.384