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Medical research on xalatan
Br J Ophthalmol. 2008 Jun 27;
Quaranta L, Pizzolante T, Riva I, Haidich AB, Konstas AG, Stewart WC
Purpose: To evaluate 24-hour intraocular pressure (IOP) and blood pressure (BP) with bimatoprost or latanoprost in patients with normal-tension glaucoma. Design: Prospective, randomized, crossover, active-controlled, observer-masked study. Methods: After a 6 week medicine-free period, we randomized patients to either latanoprost or bimatoprost for 8 weeks and then to the opposite medicine for 8 weeks. At baseline, and at the end of each treatment period, we evaluated IOP and BP at 08:00 and then every 2 hours over the 24-hour day. Diastolic ocular perfusion pressure (DOPP) was calculated from the above parameters. Results: Forty completed patients had a 24-hour untreated baseline IOP of 15.5+/-2.3 mm Hg, and a DOPP of 59.2+/-6.1 mm Hg. Both treatments lowered IOP at each time point (P/=0.29) and diastolic BP (P>/=0.12). The mean 24-hour DOPP for latanoprost was increased from baseline (3%, P=0.031) but not for bimatoprost (2%, P = 0.21). However, no difference in DOPP existed between treatments at any time point or over the 24 hour curve (P>/=0.17). No difference was observed between treatments for any adverse event (P>0.05). Conclusions: In patients with normal-tension glaucoma both bimatoprost and latanoprost reduce the 24-hour intraocular pressure from untreated baseline to a similar extent. Latanoprost is associated with slightly improved ocular diastolic perfusion pressure over 24 hours.
Curr Med Res Opin. 2008 Jun 25;
Lee CW, Buckley F, Costello S, Kelly S
AIM: To classify the comparative quantity and quality of the RCT evidence of pharmacological treatment for glaucoma.METHOD: A systematic review of MEDLINE, EMBASE Cochrane CENTRAL and relevant conference proceedings was conducted up to March 2007. RCTs recruiting adults with primary open angle glaucoma (POAG) and/or ocular hypertension (OH) receiving any topical medication or placebo were included. RCTs containing a prostaglandin treatment arm were specifically considered.RESULTS: A total of 510 publications were identified. Of these, 181 studies had a prostaglandin treatment arm. The median study duration was 12 weeks (IQR 4-13) and 78% of included trials had a duration of 3 months or less. The four studies over 1 year in duration all included a latanoprost and timolol treatment arm. There was a lack of data on younger populations (median of the mean ages of included patients was 63.4 years [IQR: 61-66 years]). Caucasians constituted 79.6% of the studied population. Evidence by ethnicity as well as by co-morbidity, was scarce. The primary outcome for 92% of studies was IOP reduction; little was reported on other indicators. Most trials reported adverse events, with hyperaemia most commonly reported.CONCLUSION: The RCT evidence base for glaucoma treatment is extensive. This systematic review is the first to consider the characteristics of all RCTs containing a prostaglandin arm. The majority of trials are of short duration and focus on IOP as the efficacy outcome. The limitations of this study are that only trials with a prostaglandin treatment arm are included and due to the large number of included trials only top line data were extracted.
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.
Curr Eye Res. 2008 May; 33(5): 477-82
Costagliola C, Campa C, Perri P, Parmeggiani F, Romano MR, Incorvaia C
PURPOSE: To verify the influence of a non-steroidal anti-inflammatory drug (NSAID), ketorolac (topical and oral) on the intraocular pressure reduction induced by 0.005% latanoprost topical administration, both in patients affected by primary open-angle glaucoma and in healthy controls. METHODS: Two groups of subjects were enrolled for this randomized, prospective, masked clinical study: 16 glaucomatous patients well controlled with 0.005% latanoprost eyedrops (group I) and 16 healthy adult volunteers (group II). Group I subjects were treated at one-week intervals with 10 mg of oral ketorolac, oral placebo, topical ketorolac, and topical placebo, respectively; for each administration modality, the switch between drug and placebo was performed in a randomized, crossover, double-blind fashion. Group II subjects followed the same protocol, with the topical once-daily 0.005% latanoprost treatment starting three days prior to the ketorolac/placebo administration. Intraocular pressure (IOP) was investigated in both groups on the day of oral/topical administration of ketorolac or placebo at baseline (8:00 AM) and at the following intervals: 1, 2, 4, 8, 12, and 24 hours. RESULTS: No significant IOP changes after oral and topical placebo administration were observed in either group. In contrast, when the subjects received ketorolac (either oral or topical), a marked decrease in IOP was recorded, with a noticeable fall at the first hour after the NSAID administration (p = 0.01), which remained still significant 8 hours later (p < 0.05). CONCLUSION: Topical and oral ketorolac strengthens the latanoprost-induced IOP-lowering effect both in glaucomatous patients and in healthy subjects.
Am J Ophthalmol. 2008 Jun 16;
Simmons ST, Bernstein P, Hollander DA
PURPOSE: To evaluate long-term intraocular pressure (IOP) fluctuation in patients with glaucoma or ocular hypertension treated with bimatoprost or latanoprost. DESIGN: Post hoc analysis of prospectively collected data from a previously reported multicenter, investigator-masked, randomized clinical trial of bimatoprost and latanoprost. METHODS: Patients were treated bilaterally with bimatoprost (n = 133) or latanoprost (n = 136) for six months. IOP measurements were taken at 8 AM, 12 PM, and 4 PM at baseline, week 1, and months 1, 3, and 6. Long-term IOP fluctuation during treatment was determined as the standard deviation (SD) of all 12 follow-up measurements. RESULTS: There was no significant between-group difference in short-term daily IOP fluctuation at baseline. Long-term IOP fluctuation over six months of treatment [mean SD (range SD)] was 1.9 (0.5 to 6.3) mm Hg with latanoprost vs 1.7 (0.5 to 3.9) mm Hg with bimatoprost (P = .050). Latanoprost-treated eyes were more likely than bimatoprost-treated eyes to have long-term IOP fluctuation of >/=3 mm Hg (7.8% vs 2.5% of eyes; P = .009). CONCLUSIONS: Bimatoprost-treated eyes demonstrated less long-term fluctuation in IOP compared with latanoprost-treated eyes in this six-month study. Additional studies are needed to confirm these findings and to determine their impact on glaucomatous progression.
Comparative study of the stability of bimatoprost 0.03% and latanoprost 0.005%: a patient-use study.
BMC Ophthalmol. 2008; 8: 11
Paolera MD, Kasahara N, Umbelino CC, Walt JG
BACKGROUND: The stability of ophthalmic preparations in multidose containers is influenced by the preservative as well as the stability of the active ingredient. Unstable drugs may require refrigeration to preserve their active ingredient level and they are more likely to degrade over time, therefore becoming more susceptible to degradation based on patient mishandling. The purpose of this study was to determine the degree of molecular degradation that occurs in bimatoprost and latanoprost in a patient-use setting. METHODS: This was an open-label, laboratory evaluation of the relative stability of bimatoprost and latanoprost. Patients presently using bimatoprost (n = 31) or latanoprost (n = 34) were identified at 2 clinical sites in Brazil. Patients were instructed to use and store their drops as usual and return all used medication bottles between day 28 and day 34 after opening. RESULTS: Bimatoprost demonstrated no degradation, but latanoprost degraded at various levels. The mean age of bimatoprost was 43.0 +/- 3.4 days and the mean age of latanoprost was 43.9 +/- 2.8 days (P = .072). The mean percentage of labeled concentration was 103.7% in the bimatoprost bottles and 88.1% in the latanoprost bottles (P < 001). CONCLUSION: This study showed that bimatoprost maintained > or =100% concentration throughout the study period while latanoprost did not.
[Prostaglandine analogues and central corneal thickness]
Oftalmologia. 2007; 51(4): 95-9
Stefan C, Dumitrica DM, Tebeanu E, Nae I, Sapundgieva A, Dragomir L
Prostaglandin analogs reduce intraocular pressure (IOP) by activation of matrixmetalloproteinase enzymes (MMP) and increasing uveoscleral outflow. MMP's were found in cornea and their activation could change the central corneal thickness (CCT). PURPOSE: To compare the effects of different prostaglandin analogues on central corneal thickness (CCT). METHODS: Clinical, observational, prospectively and randomised study during 3 month on 26 patients (52 eyes) newly diagnosed with primary open angle glaucoma or ocular hypertension. The patients were distributed in two groups concerning topical treatment: - group I: 15 patients treat with travoprost 0,004%; - group II: 11 patients treat with latanoprost 0,005%. The treatment was administrated daily at 9:00 pm, one drop. The CCT was measured for each patient for 3 times by ultrasound pachimetry: at the beginning of the study, at one month and three months. The groups were homogeneous concerning age and sex distribution. Exclusion criteria were: any topical eye drug usage, history of corneal disease or intraocular surgery. The statistic analyse was realised with Mann-Whitman test. RESULTS: The mean central corneal thickness for the two groups was similar: 521,27+/-28,54 microm for group I and 522,18+/-27,52 microm for group II. A statistically significant CCT reduction was observed in both groups: 516,88+/-28,61 microm at one month and 515,04+/-27,59 microm at three month for group I; respectively 518,41+/-27,36 microm at one month and 517,98+/-27,86 microm at three month for group II. CONCLUSIONS: The results of this study show that both classes of prostaglandin analogs reduce the mean CCT, the effect being equivalent for the both studied groups.
Eye. 2008 Jun 6;
Martinez A, Sanchez M
ObjectiveTo evaluate bimatoprost/timolol fixed combination (BTFC) vs latanoprost/timolol fixed combination (LTFC) given each evening over the 12-h intraocular pressure (IOP) diurnal curve.MethodsA total of 54 eyes of 54 patients (24 with primary open-angle glaucoma (POAG) and 30 with pseudoexfoliative glaucoma (PXG)) were included in this prospective, randomized, evaluator-masked single centre crossover study. Patients with an IOP of >/=19 mmHg, under treatment with prostaglandin analogues, were randomized to BTFC or LTFC for a 12-week treatment period after a 6-week run-in period on timolol maleate 0.5% (one drop in each eye twice each day). Patients were then switched to the opposite treatment for the second period. Six 12-h IOP curves were recorded for each patient at baseline (under treatment with timolol maleate 0.5% BID), week 6 and 12 for each treatment period.ResultsThe 12-h IOP (mean (SD)) values were 22.0 (1.0) mmHg at baseline, 17.7 (0.8) mmHg on BTFC, and 18.5 (0.8) mmHg on LTFC (P
Contact Dermatitis. 2008 Jun; 58(6): 370-1
Pérez-Rodríguez E, González-Pérez R, Poza P, Feliciano L, López-Correcher B, Matheu V
Invest Ophthalmol Vis Sci. 2008 May 23;
Quaranta L, Miglior S, Floriani I, Pizzolante T, Konstas A
Purpose. To evaluate the effect of the timolol-dorzolamide fixed combination (TDFC) and latanoprost 0.005% on 24-hour intraocular pressure (IOP), systolic (SBP) and diastolic blood pressure (DBP), and diastolic ocular perfusion pressure (DOPP), in glaucoma (POAG) patients. Setting. Institutional randomized clinical trial Methods. Following a 24-hour assessment without treatment, 27 previously untreated POAG patients were randomized to six weeks' treatment with twice-daily TDFC (08:00 and 20:00) followed by once-daily latanoprost 0.005% (20:00), or vice versa. One eye was analyzed per patient. The mean values of IOP, DBP, SBP and DOPP (difference between DBP and IOP) were recorded at each time point, and the 24-hour data are the mean values of each patient?s measurements over the 24-hour period. The differences between the values of first treatment period and the baseline, and the second treatment period and washout were calculated and analyzed by means of an analysis of variance model that tested the effects of sequence and treatment. Results. Both treatments significantly reduced 24-hour IOP (p