Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new cosopt research articles will be listed here shortly after becoming available to us.
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Medical research on cosopt
Graefes Arch Clin Exp Ophthalmol. 2008 Jun 25;
Beckers HJ, Schouten JS, Webers CA, van der Valk R, Hendrikse F
BACKGROUND: To compare the tolerability of commonly prescribed topical glaucoma medications by determining frequency and bother of side effects, patient satisfaction with their medication, and the chance of discontinuation of eye drops. METHODS: The tolerability of topical glaucoma medication was studied in glaucoma patients from nine hospitals. The frequency and severity of side effects was investigated together with patient satisfaction with the medication and the probability to change medication due to reported side effects. To register side effects of topical glaucoma medication, patients were requested to fill in a questionnaire based on "the Comparison of Ophthalmic Medications for Tolerability" (COMTOL) questionnaire supplemented with items based on the most frequently observed and severe side effects. RESULTS: The number of patients responding was 3,333 (87%). Most patients (79%) were satisfied with their eye medication. The median score for ocular side effects was 58 on a scale ranging from 0 to 320. The probability that medication would be changed by the ophthalmologist at the next visit due to reported side effects occurring since the patients' last or last but one visit to the ophthalmologist was 9%. The most frequently prescribed drugs were timolol, latanoprost, and the fixed combinations of dorzolamide/timolol (Cosopt(R)) and latanoprost/timolol (Xalcom(R)). Only small differences in tolerability were found between these drugs. CONCLUSIONS: The tolerability of timolol, latanoprost, and the fixed combinations of latanoprost/timolol (Xalcom(R)) and dorzolamide/timolol (Cosopt(R)) seem to be comparable. Patients are satisfied with their glaucoma medication and have a low chance of discontinuation of eye drops due to side effects.
High-resolution time course analysis of gene expression from pituitary.
Cold Spring Harb Symp Quant Biol. 2007; 72: 381-6
Hughes M, Deharo L, Pulivarthy SR, Gu J, Hayes K, Panda S, Hogenesch JB
In both the suprachiasmatic nucleus (SCN) and peripheral tissues, the circadian oscillator drives rhythmic transcription of downstream target genes. Recently, a number of studies have used DNA microarrays to systematically identify oscillating transcripts in plants, fruit flies, rats, and mice. These studies have identified several dozen to many hundred rhythmically expressed genes by sampling tissues every 4 hours for 1, 2, or more days. To extend this work, we have performed DNA microarray analysis on RNA derived from the mouse pituitary sampled every hour for 2 days. COSOPT and Fisher's G-test were used at a false-discovery rate of less than 5% to identify more than 250 genes in the pituitary that oscillate with a 24-hour period length. We found that increasing the frequency of sampling across the circadian day dramatically increased the statistical power of both COSOPT and Fisher's G-test, resulting in considerably more high-confidence identifications of rhythmic transcripts than previously described. Finally, to extend the utility of these data sets, a Web-based resource has been constructed (at http://wasabi.itmat.upenn.edu/circa/mouse ) that is freely available to the research community.
Saudi Med J. 2008 Mar; 29(3): 384-7
Rismanchian A, Eslami F, Moeini H, Attarzade H, Naderibeni A
OBJECTIVE: Efficacy of the latanoprost versus timolol/dorzolamide combination therapy in patients with primary open angle glaucoma METHODS: The study was designed as a 6 months randomized, observer-masked study comprising 120 patients with primary open-angle glaucoma in Feiz Hospital, Isfahan, Iran, from 2006 to 2007. The patients were randomized (latanoprost, n = 60; dorzolamide/timolol, n = 60) to treatment with either latanoprost, 0.005% once daily, or the combination of timolol 0.5% twice daily, and dorzolamide 2% 3 times daily. The mean intraocular pressure (IOP) after one, 3, and 6 months of treatment was compared with baseline in the 2 groups. RESULTS: A total of 120 patients were randomized to 2 equal treatment groups. The mean baseline IOP values were similar between the 2 groups. The mean (standard error of mean [SE]) IOP reductions at months one was 7.2 (0.4), at month 3 was 7.3 (0.4), and at month 6 was 7.1 (0.3) mm Hg for the latanoprost group and 7.5 (0.3), 7.8 (0.3), and 7.4 (0.3) mm Hg for the dorzolamide/timolol group. The 2 therapies were similarly effective. CONCLUSION: The latanoprost and dorzolamide/timolol combination were equally effective at lowering IOP compared to untreated baseline.
Curr Eye Res. 2008 Feb; 33(2): 163-8
Cvenkel B, Stewart JA, Nelson LA, Stewart WC
PURPOSE: The efficacy of dorzolamide/timolol fixed combination (DTFC) versus latanoprost/timolol fixed combination (LTFC) in open-angle glaucoma or ocular hypertensive patients. METHODS: Patients were randomized to DTFC or LTFC for 6 weeks and switched to opposite treatment for Period 2. RESULTS: Thirty-two completed patients had a mean diurnal IOP of 19.5+/-3.2 mmHg for DTFC and 18.9+/-3.4 mmHg for LTFC (p=0.12), with no significant difference found between DTFC and LTFC at any timepoint following a Bonferroni correction (p>or=0.01). CONCLUSIONS: Patients treated with DTFC and LTFC have a statistically similar ocular hypotensive effect.
Eye Contact Lens. 2008 Jan; 34(1): 21-3
Ozkurt Y, Oral Y, Karacan O, Comez A, Dogan OK
PURPOSE: To compare the effects of dorzolamide-timolol combination and brimonidine on intraocular pressure (IOP) after phacoemulsification surgery. METHODS: This prospective, randomized study included 69 eyes of 43 patients undergoing phacoemulsification and foldable intraocular lens implantation. Twenty-one patients were women and 22 were men. The mean patient age was 69.7+/-12.4 years. Patients were randomly assigned to one of three treatment groups preoperatively. Group A (n=23) received one drop of dorzolamide-timolol fixed combination and group B (n=23) received one drop of brimonidine tartrate 0.2% immediately after surgery. In group C (n=23), patients received no treatment and served as a control group. IOP was measured by Goldmann applanation tonometry 6 hours and 24 hours after surgery. RESULTS: Six hours after surgery, the mean IOP was significantly lower in group A (16.3+/-2.9 mm Hg) than in groups B (20.6+/-2.9 mm Hg) and C (24.6+/-5.4 mm Hg). However, 24 hours after surgery, the mean IOP was higher in group C (19.8+/-4.7 mm Hg) than in the other two groups (14.1+/-2.8 mm Hg in group A and 17.5+/-2.7 mm Hg in group B). CONCLUSIONS: Prophylactic treatment with dorzolamide-timolol fixed combination was more effective than brimonidine in reducing IOP 6 hours and 24 hours after phacoemulsification surgery.
Ophthalmology. 2008 Jan; 115(1): 99-103
Konstas AG, Kozobolis VP, Tsironi S, Makridaki I, Efremova R, Stewart WC
PURPOSE: To evaluate the 24-hour intraocular pressure (IOP)-lowering effect of latanoprost and the dorzolamide/timolol fixed combination (DTFC) after 2 and 6 months of treatment. DESIGN: Randomized, prospective, crossover comparison. PARTICIPANTS: Thirty-nine patients had primary open-angle glaucoma, and 14 patients had ocular hypertension. METHODS: After a 6-week washout period, patients were randomized to either 6 months of treatment with the DTFC twice daily or latanoprost every evening and then crossed over to the opposite treatment for an additional 6 months. MAIN OUTCOME MEASURE: Mean 24-hour IOP after 2 and 6 months of treatment. RESULTS: Fifty-three patients had an average 24-hour baseline IOP of 25.2+/-2.3 mmHg. After 6 months of treatment, 24-hour IOPs were 18.1+/-1.9 mmHg for the DTFC and 18.3+/-1.9 mmHg for latanoprost. Compared with 2 months of therapy, at 6 months the DTFC showed no significant change in mean 24-hour IOP, whereas latanoprost demonstrated a reduction of 0.3 mmHg (P = 0.01). The DTFC had more burning (P
Cost analysis of glaucoma medications.
Am J Ophthalmol. 2008 Jan; 145(1): 106-13
Rylander NR, Vold SD
PURPOSE: To provide patients and health care providers with calculated yearly costs of topical glaucoma medications. DESIGN: Prospective, experimental, laboratory study. METHODS: Using the average wholesale price and common dosing patterns, we calculated the theoretical yearly cost of glaucoma medications. RESULTS: Calculated yearly cost ranged from $150.81 for generic timolol maleate 0.5% (Falcon Pharmaceuticals, Ltd, Fort Worth, Texas, USA) to $697.42 for Cosopt (Merck & Co, West Point, Pennsylvania, USA), and as high as $873.98 for a three-times-daily dose of Alphagan P 0.15% (Allergan, Inc, Irvine, California, USA). Among brand name beta-blockers, yearly cost ranged between $203.47 for Timoptic 0.5% (Merck & Co) and $657.24 for Betoptic S (Alcon Laboratories, Fort Worth, Texas, USA). Generic beta-blockers consistently were more economical than their brand-name counterparts. Yearly cost of prostaglandin analogs ranged from $427.69 for Travatan (Alcon) to $577.62 for Lumigan (Allergan). The two carbonic anhydrase inhibitors Azopt (Alcon) and Trusopt (Merck & Co), yielded similar economic profiles. Alphagan P 0.15% had yearly calculated costs of $559.08 for twice daily dosing per eye. The generic selective alpha(2)-agonist brimonidine tartrate 0.2% (Bausch & Lomb Pharmaceuticals, Tampa, Florida, USA) costs approximately $352.89 and $529.34 per year for the respective two and three drops daily per eye regimens. CONCLUSIONS: Nonselective beta-blockers remain the most inexpensive class of glaucoma medications. Bottle size may impact yearly glaucoma medication expenditures. Costs of glaucoma medications may impact decision making in the medical management of glaucoma.
Curr Med Res Opin. 2007 Dec; 23(12): 3009-16
Lafuma A, Berdeaux G
OBJECTIVE: To compare the effectiveness and associated costs of travoprost versus a fixed combination of dorzolamide + timolol as first-line therapy for glaucoma according to data collected by the United Kingdom General Practitioner Research Database (UK-GPRD). METHODS: Patients with a diagnosis of ocular hypertension, glaucoma, or who had been treated topically by surgery or laser therapy were selected. Patients starting first-line treatment with travoprost or a fixed dorzolamide + timolol combination were included. Times to treatment failure were compared with an adjusted Cox model. MAIN OUTCOME MEASURES: Cost and treatment failure defined as a prescription change (adding or removing a topical treatment, or initiating laser therapy or surgery). RESULTS: 56 612 patients were extracted from the database and 39 808 patients received at least one topical prescription for IOP-lowering (intraocular pressure) therapy. Of these, 639 were treated with travoprost and 387 with dorzolamide + timolol, as first-line therapies. No significant difference was found between patient characteristics. Patients were aged 70.0 years and 48.5% were male. At 1 year, treatment failure was experienced by 30.4% of patients receiving travoprost and 49.4% receiving dorzolamide + timolol (p < 0.001). The hazard ratio for failure was 0.79 (p < 0.03) less with travoprost, after adjusting on age, gender, comorbidities and duration of follow-up. Adjusted annual costs of glaucoma management were significantly (p < 0.001) lower with travoprost ( pound198.31) than with dorzolamide + timolol ( pound312.21). CONCLUSION: This retrospective costs and consequences analysis study showed that travoprost is more efficient than dorzolamide + timolol as first-line therapy for glaucoma patients. Patients continued longer with first-line treatment when prescribed travoprost at a lower cost.
Clin Experiment Ophthalmol. 2007 Sep-Oct; 35(7): 602-11
Rait JL, Adena MA
BACKGROUND: Effective management of ocular hypertension requires patients to be persistent with their treatment regimen. We evaluated patients' persistency with hypotensive eyedrops commonly used to treat glaucoma and ocular hypertension. METHODS: This large, population-based, retrospective, cohort study used pharmacy claims data for concessional patients from the Australian Pharmaceutical Benefits Scheme (July 1999-June 2005). Resupply rates for prostaglandins, beta-blockers, alpha-agonists and carbonic anhydrase inhibitors were analysed using life tables and Cox regression. Two populations, based on patients' supply histories, were examined: (i) 'new to this eyedrop'- patients who had used other hypotensive eyedrops before (presumably, previously diagnosed with glaucoma or ocular hypertension); and (ii) 'new to any eyedrop'- patients who were using their first hypotensive eyedrop (presumably, newly diagnosed with glaucoma or ocular hypertension). RESULTS: Data were obtained for 14,359,618 supplies of commonly used hypotensive eyedrops to 357,099 concessional patients. For both populations, resupply rates were highest for prostaglandins or the dorzolamide-timolol combination eyedrops, compared with beta-blockers, alpha-agonists or carbonic anhydrase inhibitors. Among the prostaglandins, there was no significant difference in the risk of ceasing supply between latanoprost and bimatoprost, but the risk was significantly higher for travoprost. CONCLUSIONS: Based on resupply rates from a national pharmacy claims database, patients supplied with ocular hypotensive eyedrops were most persistent with prostaglandin (bimatoprost, latanoprost and travoprost) and dorzolamide-timolol combination eyedrops. Among the prostaglandins, persistency was highest with, and similar between, bimatoprost and latanoprost. Persistency should be taken into account when selecting the most appropriate eyedrop to treat glaucoma and ocular hypertension.
J Cataract Refract Surg. 2007 Oct; 33(10): 1754-9
Wirtitsch MG, Menapace R, Georgopoulos M, Rainer G, Buehl W, Heinzl H
PURPOSE: To assess the safety, in terms of the intraocular pressure (IOP), of cataract surgery with primary posterior continuous curvilinear capsulorhexis (PPCCC) and a postoperative dose of a fixed dorzolamide-timolol combination and evaluate the effect of intraocular lens (IOL) haptic angulation. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: In this prospective randomized double-masked bilateral study, 88 eyes of 44 consecutive patients with age-related cataract were included in an intraindividual comparison study. All patients had standardized cataract surgery with PPCCC and IOL implantation in the capsular bag followed by a postoperative dose of a fixed dorzolamide-timolol combination. Patients were randomly assigned to receive an ACR6D SE IOL (Laboratoires Cornéal) in 1 eye and a Centerflex (C-flex) 570C IOL (Rayner Surgical GmbH) in the contralateral eye. The IOP was measured at baseline and postoperatively at 6 and 24 hours as well as 1 week. RESULTS: Intraindividual comparison showed statistically significantly higher IOP measurements in the C-flex 570C nonangulated IOL group than in the ACR6D SE angulated IOL group at 24 hours (P = .003) and 1 week (P = .043). The highest IOP spikes (34 mm Hg) were at 6 hours in 2 eyes with a C-flex 570C IOL. The ACR6D SE group had statistically significant changes in IOP between preoperative and all postoperative time points. In the C-flex 570C group, the only statistically significant change in IOP was between preoperatively and 6 hours postoperatively. CONCLUSIONS: Cataract surgery with PPCCC was safe in terms of the postoperative IOP course. Haptic angulation slightly decreased the overall IOP rise and the incidence of IOP rises above 30 mm Hg.