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Vol. 42, No. 2, 2009
Issue release date: September 2009
Ophthalmic Res 2009;42:99–105

Systematic Review of Intraocular Pressure-Lowering Effects of Adjunctive Medications Added to Latanoprost

Cheng J.-W. · Li Y. · Wei R.-L.
Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China

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Objective: To evaluate the intraocular pressure (IOP)-lowering effects of adjunctive medications when added to 0.005% latanoprost taken once daily. Methods: Pertinent publications were identified through systematic searches of PubMed, Embase, and the Cochrane Controlled Trials Register. Randomized clinical trials with over 85% of patients presenting with primary open-angle glaucoma or ocular hypertension who were treated with the combination treatment of latanoprost were selected. The pooled additional IOP-lowering effects at 1–3 months after a run-in phase of at least 2 weeks on 0.005% latanoprost once daily were calculated using the random effects model. Results: Nine randomized clinical trials were included. The mean pooled IOP reductions were 3.3 mm Hg (95% CI: 2.1–4.5) at trough and 4.4 mm Hg (95% CI: 3.4–5.4) at peak when adding 0.5% timolol once daily, 2.6 mm Hg (95% CI: 1.9–3.3) at trough and 3.8 mm Hg (95% CI: 2.5–5.2) at peak when adding 0.1/0.15% brimonidine twice daily, 2.6 mm Hg (95% CI: 1.7–3.4) at trough and 3.1 mm Hg (95% CI: 2.6–3.6) at peak when adding 2% dorzolamide twice daily, 2.4 mm Hg (95% CI: 2.0 –2.8) at trough and 2.7 mm Hg (95% CI: 2.2–3.2) at peak when adding 0.5% timolol twice daily, and 2.8 mm Hg (95% CI: 1.5–4.1) at trough and 1.8 mm Hg (95% CI: 1.2–2.3) at peak when adding 1% brinzolamide twice daily. Conclusions: The addition of brimonidine, dorzolamide, timolol, or brinzolamide can further lower IOP in eyes being treated with latanoprost. Timolol 0.5% once daily might be the most effective adjunctive medication.

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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