Additivity of Bimatoprost or Travoprost to Latanoprost in GlaucomatousMonkey Eyes | Glaucoma | JAMA Ophthalmology | JAMA Network
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Laboratory Sciences
September 2004

Additivity of Bimatoprost or Travoprost to Latanoprost in GlaucomatousMonkey Eyes

Author Affiliations

From the Department of Ophthalmology, Mount Sinai School of Medicineof New York University, New York. Dr Podos is a consultant to Alcon Laboratories,Inc; Allergan, Inc; Sucampo, Inc; and Pfizer, Inc.

Arch Ophthalmol. 2004;122(9):1342-1347. doi:10.1001/archopht.122.9.1342

Objective  To compare the ocular hypotensive effect of the commercially availablepreparations of bimatoprost or travoprost added to latanoprost in monkey eyeswith laser-induced unilateral glaucoma.

Methods  Four monkeys with unilateral laser-induced glaucoma were used in eachtreatment group and received drops in the glaucomatous eye only. Intraocularpressure (IOP) was measured hourly for 6 hours, beginning at 9:30 AM on day 1 (untreated baseline), days 6 and 7 (single-agent therapy),and days 13 and 14 (2-drug combination therapy). On days 2 through 7, 1 dropof the scheduled single agent was given immediately after the 9:30 AM IOP measurement, and on days 8 through 14, the second scheduleddrug was given 5 minutes after the first. The following 5 different dosingprotocols were studied: latanoprost with bimatoprost added, bimatoprost withlatanoprost added, latanoprost with travoprost added, travoprost with latanoprostadded, and latanoprost with a second dose of latanoprost added.

Results  There were no statistically significant (P =.95) differences among the mean baseline IOPs in any of the 5 treatment groups.When applied as single agents, latanoprost, bimatoprost, and travoprost allproduced significant (P<.05) and equivalent (P = .98) reductions in IOP. The mean ±SEM maximumreduction (P<.05) from baseline IOP was 7.0 ±0.4 mm Hg (20% reduction) with travoprost alone, 6.5 ± 1.6 mm Hg (18%)with bimatoprost alone, and 7.5 ± 1.0 mm Hg (22%) with latanoprostalone. The mean ±SEM maximum additive reductions in IOP were 3.0 ±0.6 mm Hg (P<.05) for travoprost added to latanoprost;2.0 ± 0.4 mm Hg (P<.05) for latanoprostadded to travoprost; 4.8 ± 1.3 mm Hg (P<.05)for bimatoprost added to latanoprost; 4.3 ± 0.6 mm Hg (P<.05) for latanoprost added to bimatoprost; and 0.3 ± 0.5mm Hg (P>.60) for latanoprost added to itself. Thecombination of bimatoprost and latanoprost produced a greater (P<.05) lowering of IOP at trough and peak than the combination oftravoprost and latanoprost.

Conclusions  Latanoprost, bimatoprost, and travoprost used as monotherapy producedsignificant and equivalent reductions in IOP in glaucomatous monkey eyes.The IOP effects of the commercial concentrations of bimatoprost or travoprostwere additive to that of latanoprost, with bimatoprost showing a greater additiveresponse than travoprost.

Clinical Relevance  Because treatment with multiple medications is common among patientswith glaucoma, determining which glaucoma medications produce an additiveocular hypotensive response when used in combination has practical implicationsfor clinicians.