Comparative acute effects of brimonidine 0.2% versus dorzolamide 2% combined with beta-blockers in glaucoma.

Abstract

PURPOSE:

To assess the acute intraocular hypotensive efficacy of brimonidine tartrate 0.2% (a highly selective alpha2-adrenergic agonist) compared with dorzolamide 2% (a topical carbonic anhydrase inhibitor) as adjunct therapy to topical beta-blockers in patients with primary open-angle glaucoma.

METHODS:

A randomized cross-over masked study was performed. We enrolled one eye of each of 28 patients who were on different beta-blocker therapy. We measured the intraocular pressure (IOP) 2 h after the beta-blocker instillation; we then randomly administered one of the two drugs and we compiled an IOP diurnal curve. One month later we repeated the same procedures with the second drug. Unpaired Mann-Whitney U-test was used to compare decreases in IOP between the two drugs (P<0.05).

RESULTS:

Both brimonidine 0.2% and dorzolamide 2% have good ocular hypotensive efficacy, significantly lowering IOP when compared to beta-blocker therapy alone, for the whole diurnal curve. Maximum mean percent IOP decrease from baseline was 22.0+/-15.7% (4.0+/-2.9 mmHg) for dorzolamide 2% 6 h after instillation and 35.5+/-16.4% (7.0+/-4.1 mmHg) for brimonidine 0.2% 8 h after administration of the drug. When we compared the two treatments, brimonidine 0.2% showed a higher hypotensive effect than 2% dorzolamide after 4 h (28.4+/-16.8% vs 17.6 +/-9.3%; P=0.04) and 8 h (35.5+/-16.4% vs 21.6 +/-10.8%; P=0.04).

CONCLUSION:

This study indicates that 0.2% brimonidine acutely associated with beta-blockers is an interesting new combination treatment useful in the management of glaucoma.

• Authors: M Centofanti, G Manni, D Gregori, F Cocco, D Lorenzano, M G Bucci
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 238 Issue 4 Pg. 302-5 (Apr 2000) ISSN: 0721-832X [Print] Germany
• PMID: 10853928 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Adrenergic alpha-Agonists
• Adrenergic beta-Antagonists
• Carbonic Anhydrase Inhibitors
• Ophthalmic Solutions
• Quinoxalines
• Sulfonamides
• Thiophenes
• Brimonidine Tartrate
• dorzolamide

Topics

• Adrenergic alpha-Agonists (administration & dosage, therapeutic use)
• Adrenergic beta-Antagonists (administration & dosage, therapeutic use)
• Aged
• Aged, 80 and over
• Brimonidine Tartrate
• Carbonic Anhydrase Inhibitors (administration & dosage, therapeutic use)
• Cross-Over Studies
• Double-Blind Method
• Drug Therapy, Combination
• Female
• Glaucoma, Open-Angle (drug therapy)
• Humans
• Intraocular Pressure (drug effects)
• Male
• Middle Aged
• Ophthalmic Solutions (administration & dosage, therapeutic use)
• Quinoxalines (administration & dosage, therapeutic use)
• Sulfonamides (administration & dosage, therapeutic use)
• Thiophenes (administration & dosage, therapeutic use)
• Tonometry, Ocular
• Treatment Outcome