Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new travatan research articles will be listed here shortly after becoming available to us.
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Medical research on travatan
Br J Ophthalmol. 2008 Nov 19;
Konstas AG, Mikropoulos D, Haidich AB, Ntampos KS, Stewart WC
OBJECTIVE: To evaluate the 24-hour efficacy and safety of the travoprost/timolol maleate fixed combination (TTFC) versus travoprost when both are dosed in the evening in primary open-angle glaucoma patients. METHODS: Prospective, double-masked, crossover, active-controlled, randomized 24-hour comparison. After a 6 week medicine-free period, patients were randomized to either TTFC or travoprost for 8 weeks and were then switched to the opposite treatment for another 8 weeks. At the end of the washout and treatment periods a 24-hour pressure curve was performed. RESULTS: Thirty-two patients completed the study. The TTFC group demonstrated a lower absolute intraocular pressure levels for the 24-hour curve and at all time points (P inverted exclamation markU0.047). The pressure reduction from untreated baseline was significantly different between treatments for all time points (P=0.018). The mean 24-hour pressure fluctuation was lower with TTFC (3.0 mm Hg) compared to travoprost (4.0 mm Hg, P=0.001). No statistical difference existed between the two treatment groups for any adverse event (P>0.05). CONCLUSIONS: This study suggests that when both drugs are dosed in the evening the TTFC provides improved intraocular pressure reduction over the 24-hour curve and for each individual time point in primary open-angle glaucoma patients.
Br J Ophthalmol. 2008 Nov 19;
Honrubia F, Garcia-Sánchez J, Polo V, Martinez-de-la-Casa JM, Soto J
AIM: To conduct a meta-analysis of randomized clinical trials (RCTs) in order to evaluate the development of conjunctival hyperemia after the use of latanoprost versus travoprost and bimatoprost, in patients with ocular hypertension or glaucoma. METHODS: In order to identify the potentially relevant RCTs, a systematic literature retrieval was conducted in Medline, Embase and Cochrane Controlled Trials Register (1995-April 2007) databases The outcome measure was the appearance of conjunctival hyperemia during the study. Statistical analyses included the calculation of odds ratio (OR) and its respective confidence interval, along with inter-trial statistical heterogeneity. Publication bias was evaluated through a funnel plot and a sensitivity analysis was also performed. RESULTS: In total, 13 RCTs involving 2,222 patients with ocular hypertension or glaucoma were included, 5 comparing latanoprost versus travoprost, 7 comparing latanoprost versus bimatoprost and 1 comparing latanoprost versus travoprost and bimatoprost. The combined results showed that latanoprost produced lower occurrance of conjunctival hyperemia than both travoprost (OR = 0.51; 95 % CI: 0.39-0.67, p < 0.0001) and bimatoprost (OR = 0.32; 95 % CI: 0.24-0.42, p < 0.0001). No significant heterogeneity was found between the included RCTs. There was no evidence of publication bias. In the sensitivity analysis performed, none of clinical trials included in this meta-analysis has an important impact in the global estimation of OR. CONCLUSIONS: According to available data, the use of latanoprost is associated with a lower incidence of conjunctival hyperemia when compared to travoprost and bimatoprost in the treatment of patients with ocular hypertension or glaucoma.
Clin Drug Investig. 2008; 28(12): 767-76
Denis P, Lafuma A, Jeanbat V, Laurendeau C, Berdeaux G
OBJECTIVE: The aim of this study was to confirm randomized clinical trial results showing that a fixed timolol/travoprost combination (TT; DuoTrav((R))) controls intraocular pressure (IOP) better than a fixed timolol/latanoprost combination (TL; Xalacom((R))) in everyday ophthalmic practice, when measured in the morning and >24 hours after instillation. METHODS: Patients with ocular hypertension or primary open angle glaucoma stabilized on TT or TL were included in this retrospective cross-sectional study. Data on demographics, medical history and previous treatments were extracted from the patients' medical records. Last treatment instillation times and IOP values were recorded at clinic visits. Treatments were compared by analyses of variance, logistic regressions and propensity scores adjusted for confounding factors. RESULTS: Out of 316 patients included, 124 instilled TT, 192 instilled TL and 266 (84.2%) overall had instilled their eye drops within 24 hours. The patients' mean age was 64.5 years and 51.6% were female. Treatment groups were comparable except for longer disease and treatment durations in TL recipients. Worse eye mean IOPs were 25.8 mmHg at diagnosis and 21.9 mmHg on starting their designated fixed combination treatment. The best IOP control was provided by TT instillations (mean IOP 17.1 and 19.0 mmHg in the TT and TL groups, respectively; p < 0.001). This difference was reinforced by results in the subgroup of patients who instilled treatment >24 hours prior to IOP measurement (mean IOP 17.0 and 20.3 mmHg in the TT and TL groups, respectively; p < 0.004). Also, 82.6% of TT patients satisfied their ophthalmologists' IOP targets versus 51.1% of TL patients (p < 0.001). All significant differences persisted after adjustment for confounding factors. CONCLUSION: This study, conducted in routine ophthalmic practice, confirmed published clinical trial results showing that TT provides better IOP control than TL when measured in the morning, and that travoprost has longer-lasting residual effects than latanoprost when IOP is measured >24 hours after instillation. However, readers should interpret these findings in the context of a cross-sectional observational study conducted in a naturalistic setting.
Prostanoids for the management of glaucoma.
Expert Opin Drug Saf. 2008 Nov; 7(6): 801-8
Arranz-Marquez E, Teus MA
BACKGROUND: Prostanoids are the newest pharmacologic group of ocular hypotensive drugs for clinical management of glaucoma. The group includes four chemical compounds structurally derived from naturally-occurring prostaglandin (PG) F(2). Prostanoids have been divided into PG analogues (unoprostone, latanoprost and travoprost) and prostamides (bimatoprost) because of differences in molecular structures. The drugs share a novel mechanism of action that produces a potent ocular hypotensive effect and a novel local adverse effect of increased iridial pigmentation. OBJECTIVE: To summarise the pharmacologic and clinical data regarding the effectiveness and safety of prostanoids in clinical glaucoma management. METHODS: The review was supported by a literature search of peer-reviewed publications, based on medical information available in databases such as PubMed. RESULTS/CONCLUSION: The prostanoids began a treatment revolution not only because of their novel mechanism of action but also as a result of a new local side effect.
Effects of oxidative stress in trabecular meshwork cells are reduced by prostaglandin analogues.
Invest Ophthalmol Vis Sci. 2008 Nov; 49(11): 4872-80
Yu AL, Fuchshofer R, Kampik A, Welge-Lüssen U
PURPOSE: The trabecular meshwork (TM) of glaucomatous eyes is characterized by cell loss, increased accumulation of extracellular matrix (ECM), and cellular senescence. One factor increasingly discussed in the pathogenesis of primary open-angle glaucoma (POAG) is oxidative stress. The goal of this study was to determine whether oxidative stress is able to trigger these typical glaucomatous changes in vitro and whether these oxidative stress-induced TM changes can be reduced by the application of prostaglandin analogues. METHODS: Cultured human TM cells were exposed to 200 to 800 microM hydrogen peroxide (H(2)O(2)) for 1 hour. Cell loss was detected by cell-viability assay. Levels of fibronectin and MMP-2 mRNA were determined by real-time PCR analysis. Senescence-associated beta-galactosidase (SA-beta-Gal) activity was investigated by histochemical staining. The effects of prostaglandin analogues and benzalkonium chloride (BAC) on these glaucoma typical TM changes were investigated by preincubation of nonstressed or H(2)O(2)-treated cells with 1:100 diluted commercial solutions of bimatoprost, travoprost, and latanoprost or their corresponding BAC concentrations. RESULTS: H(2)O(2) induced cell death and fibronectin mRNA expression, but decreased the amount of MMP-2 mRNA. H(2)O(2) increased SA-beta-Gal activity. Additional pretreatment with BAC further increased the typical glaucomatous TM changes in vitro. These effects were reduced by preincubation with prostaglandin analogues in H(2)O(2)-treated and, to a lesser extent, in nonstressed cells. No reduction occurred in the presence of prostaglandin F receptor antagonists in H(2)O(2)-treated cells. CONCLUSIONS: Oxidative stress is able to induce characteristic glaucomatous TM changes in vitro, and these oxidative stress-induced TM changes can be minimized by the use of prostaglandin analogues. Thus, prevention of oxidative stress exposure to the TM may help to reduce the progression of POAG.
[Cost-efficacy analysis of fixed combinations of prostaglandin/prostamide for treating glaucoma.]
Arch Soc Esp Oftalmol. 2008 Oct; 83(10): 595-600
Martínez A, Slof J
OBJECTIVE: To assess the cost-efficacy of three fixed-combination glaucoma treatments currently available in Spain [bimatoprost with timolol (BT)- Ganfort(R), latanoprost with timolol (LT)- Xalacom(R), and travoprost with timolol (TT)- DuoTrav(R)]. METHODS: Because no studies are available that give a direct comparison of these drugs, a systematic review was carried out to assess their efficacy. Resource consumption and costs were estimated using a model of usual local practice. For each of the three drugs, average and incremental cost-efficacy ratios were determined in terms of euros per percentage point of reduction of intraocular pressure (IOP) over a three-month period. RESULTS: BT reduced IOP by 35.1%, LT by 35.0% and TT by 34.7%. Average cost-efficacy was estimated to be euro 5.34 per percentage point of IOP reduction with BT, euro 5.40 with LT, and euro 5.45 with TT. Incremental cost-efficacy (incremental cost per incremental percentage point of IOP reduction) was estimated to be euro 94.65 for LT vs. TT, and was negative for BT vs. TT and BT vs. LT, since in both cases BT was more efficacious and less expensive. CONCLUSIONS: Compared to travoprost/timolol and latanoprost/timolol, bimatoprost/timolol appears to be the most economic alternative, with equal or better efficacy and safety results (Arch Soc Esp Oftalmol 2008; 83: 595-600).
Curr Med Res Opin. 2008 Sep 29;
Yan DB, Battista RA, Haidich AB, Konstas AG
OBJECTIVE: To compare the IOP-lowering efficacy of a.m.-dosed travoprost and latanoprost at 24-h post-dose.RESEARCH DESIGN AND METHODS: Open-angle glaucoma patients not naïve to prostaglandin therapy and currently controlled on p.m.-dosed (2100) latanoprost (n = 21) or travoprost (n = 30) had baseline IOPs measured at 0900. In a randomized, single-masked, crossover design, patients received travoprost (Travatan) or latanoprost (Xalatan) at 0900 for 4 weeks, then were crossed over to receive the second prostaglandin for another 4 weeks. Treatment IOP was measured at 0900 prior to morning dose at both 4 and 8 week visits. Patient dosing preference (a.m./p.m.) was surveyed on exit. MAIN OUTCOME MEASURE: Intraocular pressure (IOP).RESULTS: The mean IOP in the first period when all patients were dosed in the evening was assessed 12 h after dosing at 09:00 and it was similar in the two treatment groups (mean +/- standard deviation: 17.9 +/- 2.7 mmHg for travoprost versus 17.7 +/- 2.5 mmHg for latanoprost, p = 0.812). In the a.m.-dosing crossover comparison, the 24-h post-dose IOP was significantly lower ( p < 0.001) on travoprost (16.9 +/- 3.1 mmHg) compared to latanoprost (18.6 +/- 3.3 mmHg). In the exit survey, 51% of patients preferred a.m.-dosing.CONCLUSIONS: a.m.-dosed travoprost is superior to a.m.-dosed latanoprost by 1.7 mmHg at 24-h post-dose.
Cesk Slov Oftalmol. 2008 Jul; 64(4): 144-8
Skorkovská K
AIM: To compare intraocular pressure (IOP) lowering efficacy of bimatoprost 0.03% / timolol 0.5% fixed combination (BTFC) and other combinations of glaucoma drugs (bimatoprost, latanoprost 0.005% / timolol 0.5% fixed combination, separate use of travoprost 0.004 % and timolol 0.5 %) in patients with glaucoma. PATIENTS AND METHODS: Fifty-three patients with glaucoma were divided into 3 groups according to their original glaucoma therapy. BTFC was used by the patients for a period of 3 months. After 1 week, 1, 2 and 3 months, the diurnal IOP curves were performed. Side effects of the new treatment were recorded and compared to the original therapy. RESULTS: The mean diurnal IOP reduction in the group of patients switching from bimatoprost to BTFK reached 4.4 +/- 2.28 mm Hg (p < 0.01). In the group of patients initially on latanoprost / timolol fixed combination, the IOP decreased with BTFK by 2.3 +/- 1.5 mm Hg (p < 0.01). Changing therapy from travoprost / timolol seperate combination to BTFK caused an IOP decrease by 2.3 +/- 1.5 mm Hg on average (p < 0.01). Conjunctival hyperemia with initial therapy was experienced in 33% of patients in our study group. With BTFK application, the hyperemia improved in 69% of these patients, got worse in 12.5% and remained unchanged in 19% of the patients. Patients found the BTFK better than the original medication in 37.5% of cases, the same in 52% and worse in 10.5%. Five patients terminated the study earlier due to poor IOP compensation or marked side effects of BTFK. CONCLUSION: In all three groups of glaucoma patients there was a significant and prolonged decrease in IOP after treatment with BTFK. The use of BTFK was accompanied by smaller incidence of conjunctival hyperemia compared to isolated bimatoprost or travoprost / timolol combination.
Am J Ophthalmol. 2008 Aug 28;
Alasbali T, Smith M, Geffen N, Trope GE, Flanagan JG, Jin Y, Buys YM
PURPOSE: To investigate the relationship between industry- vs nonindustry-funded publications comparing the efficacy of topical prostaglandin analogs by evaluating the correspondence between the statistical significance of the publication's main outcome measure and its abstract conclusions. DESIGN: Retrospective, observational cohort study. METHODS: English publications comparing the ocular hypotensive efficacy between any or all of latanoprost, travoprost, and bimatoprost were searched from the MEDLINE database. Each article was reviewed by three independent observers and was evaluated for source of funding, study quality, statistically significant main outcome measure, correspondence between results of main outcome measure and abstract conclusion, number of intraocular pressure outcomes compared, and journal impact factor. Funding was determined by published disclosure or, in cases of no documented disclosure, the corresponding author was contacted directly to confirm industry funding. Discrepancies were resolved by consensus. The main outcome measure was correspondence between abstract conclusion and reported statistical significance of the publications' main outcome measure. RESULTS: Thirty-nine publications were included, of which 29 were industry funded and 10 were nonindustry funded. The published abstract conclusion was not consistent with the results of the main outcome measure in 18 (62%) of 29 of the industry-funded studies compared with zero (0%) of 10 of the nonindustry-funded studies (P = .0006). Twenty-six (90%) of the industry-funded studies had proindustry abstract conclusions. CONCLUSIONS: Twenty-four percent of the industry-funded publications had a statistically significant main outcome measure; however, 90% of the industry-funded studies had proindustry abstract conclusions. Both readers and reviewers should scrutinize publications carefully to ensure that data support the authors' conclusions.
Additive effect of dorzolamide hydrochloride to patients taking travoprost: a retrospective study.
Optometry. 2008 Sep; 79(9): 501-4
Boyer S, Gay D
BACKGROUND: A retrospective chart review study at a Veterans Affairs hospital evaluated intraocular pressure change after dorzolamide hydrochloride 2% was administered to patients already using travoprost. A literature search found no other study that looked specifically at this combination of drugs. METHODS: A chart review of 46 patients at the Veterans Affairs Illiana Health Care System was performed evaluating the intraocular pressures after dorzolamide hydrochloride was added to travoprost. Baseline intraocular pressures were obtained on patients who had been on travoprost at least 4 months. Endpoint intraocular pressures were then obtained from the visit closest to 6 months after the addition of dorzolamide hydrochloride. RESULTS: An average intraocular pressure reduction of an additional 20.6% was observed after adding only dorzolamide hydrochloride to travoprost. CONCLUSIONS: This study confirmed our clinical observations that dorzolamide hydrochloride added to travoprost is an excellent and safe choice to further lower intraocular pressures.