| Peer-Reviewed

Pressure lowering effect of fixed combination and unfixed- combination of latanoprost and timolol in Asian population

Received: 15 December 2012    Accepted:     Published: 30 December 2012
Views:       Downloads:
Abstract

Introduction: Fixed combination of topical pressure lowering drugs such as latanoprost and timolol (FCLT) has been reported to improve adherence and persistence to medication for chronic disease such as glaucoma. However, its effectiveness has been reported to be less compared to unfixed combination of latanoprost and timolol (UFCLT). Objective: To compare the efficacy of FCLT and UFCLT in Malaysian population. Methods: A non randomized prospective cohort study was conducted from January 2006 to December 2010 involving primary open-angle glaucoma (POAG), ocular hypertension (OHT) and normal-tension glaucoma (NTG) patients who failed to achieve target pressure or demonstrated progression of the disease while on monotherapy treatment with topical timolol XE 0.5% in eye clinic of Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kelantan, Malaysia. A total of 120 glaucoma patients were recruited with 58 were prescribed FCLT and 62 were treated with UFCLT. UFCLT is combination of topical timolol XE 0.5% and latanoprost 0.005%. Intraocular pressure (IOP) was taken at baseline and 3, 6, 9, 12 months post treatment. Results: A total of 95 patients completed the 12 months follow up (47 in FCLT group and 48 in UFCLT). Mean age was 61.0 SD 14.5 years old. Majority of cases were POAG (79%), followed by NTG (12%) and OHT (9%). Mean baseline IOP was 23.9 SD 5.9 mmHg and 19.9 SD 5.6 mmHg in UFCLT and FCLT groups respectively. Mean IOP reduction between baseline and final measurement in UFCLT and FCLT groups were -8.1 mmHg vs.-3.6 mmHg respectively (p<0.001). Based on repeated measures analysis of variance (RM ANOVA) and repeated measures analysis of covariance (RM ANCOVA) model, there was significant difference between UFCLT and FCLT (p =0.002). Conclusions: Both UFCLT and FCLT provide pressure lowering effect in Malaysian population. UFCLT provides significant better pressure lowering effect than FCLT. FCLT provides less inter-visit pressure fluctuation.

Published in Clinical Medicine Research (Volume 1, Issue 1)
DOI 10.11648/j.cmr.20120101.12
Page(s) 7-12
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Combination Therapy, Latanoprost, Timolol, Ocular Hypertension, Open-Angle Glaucoma, Normal-Tension Glaucoma

References
[1] Burr, J., Azuara-Blanco, A. & Avenell, A. (2004). Medical versus surgical interventions for open angle glaucoma. Status and date: Edited (no change to conclusions), published in, in The Cochrane Library 2009, Issue 1.
[2] Kass MA, Heuer DK, Higginbotham EJ, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002; 120:701C713
[3] Heijl A, Leske MC, Bengtsson B, et al. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. 2002; 120:1268C1279
[4] Hitchings, R. & Tan, J. (2001). Target pressure. J Glaucoma, 10(5), S68.
[5] Schwartz, G. F. (2005). Compliance and persistency in glaucoma follow-up treatment. Curr Opin Ophthalmol, 16(2), 114.
[6] Høvding, G. & Aasved, H. (1987). Timolol/pilocarpine combination eye drops in open angle glaucoma and in ocular hypertension. Acta Ophthalmologica, 65(5), 594-601.
[7] Lee PY, Shao H, Camras CB, Podos SM (1991). Additively of prostaglandin F2 alpha-1-isopropyl ester to timolol in glaucoma patients. Ophthalmology; 98: 1079C1082.
[8] Rulo AH, Greve EL, Hoyng PF. Additive effect of latanoprost, a prostaglandin F2 alpha analogue, and timolol in patients with elevated intraocular pressure. Br J Ophthalmol 1994; 78: 899C902.
[9] Pfeiffer N. The German Latanoprost Fixed Combination Study Group. A comparison of the fixed combination of latanoprost and timolol with its individual components. Graefes Arch Clin Exp Ophthalmol. 2002; 240:893C899
[10] Shin D, Feldman RM, Sheu WPS. Efficacy and safety of the fixed combinations latanoprost/timolol versus dorzolamide/timolol in patients with elevated intraocular pressure. Ophthalmology. 2004; 111: 276C282
[11] Higginbotham EJ, Feldman R, Stiles M, et al. Latanoprost and timolol combination therapy versus monotherapy. Arch Ophthalmol. 2002; 120:915C922
[12] Patel SC, Spaeth GL. Compliance in patients prescribed eye drops for glaucoma. Ophthalmic Surg 1995; 26: 233C236
[13] Kass, M., Gordon, M., Morley Jr, R., Meltzer, D. & Goldberg, J. (1987). Compliance with topical timolol treatment. Am J Ophthalmol, 103(2), 188
[14] Anderson DR, Drance SM, Schulzer M; Collaborative Normal CTension Glaucoma Study (2001). Natural history of normal-tension glaucoma. Ophthalmology; 108 (2), 247-53
[15] Gordon MO, Kass MA. The Ocular Hypertension Treatment Study: design and baseline description of the participants (1999). Arch Ophthalmol; 117 (5), 573-83.
[16] Otaleju SO and Ajayi AA (1999). The lack of efficacy of topical beta-blockers, timolol and betaxolol on intraocular pressure in Nigerian healthy volunteers, Eye, 13, 758-763
[17] Orengo-Nania S, Landry T, Von-Tress M, et al. Evaluation of travoprost as adjunctive therapy in patients with uncontrolled intraocular pressure while using timolol 0.5%. Am J Ophthalmol. 2001; 132:860C868.
[18] Stewart WC, Day DG, Holmes KT, Stewart JA (2001). Effect of timolol 0.5% gel and solution in pulmonary function in older glaucoma patients. J Glaucoma; 10: 227-232.
[19] Bengtsson, B., Leske, M. C., Hyman, L. & Heijl, A. (2007). Fluctuation of intraocular pressure and glaucoma progression in the early manifest glaucoma trial. Ophthalmology, 114(2), 205-209
[20] Backman C, Csenblad N-G. A 6-month randomized, double-masked comparison of fixed combination of latanoprost and timolol with the individual components, continuing into a 6- month open label safety study of fixed combination in patients with glaucoma or ocular hypertension.A multicenter study in Germany.Pharmacia & Upjohn Report c0013595, 1999.
[21] Hodapp E, Parrish RK II, Anderson DR. Clinical decisions in glaucoma. St Louis: The CV Mosby Co; 1993: 52-61.
[22] Leske, M. Cristinaa; Heijl, Andersb; Hyman, Lesliea et.al: Factors for progression and glaucoma treatment: The Early Manifest Glaucoma Trial (2004). J Glaucoma; 15:102-106.
[23] Roselund EF (1996). The intraocular pressure lowering effect of timolol in gel-forming solution. Acta Ophthalmol Scand; 74, 160-162
[24] Katz, I. M. & Berger, E. T. (1979). Effects of iris pigmentation on response of ocular pressure to timolol. Surv Ophthalmol, 23(6), 395-398
[25] van der Valk, R., Webers, C. A. B., Schouten, J. S. A. G., Zeegers, M. P., Hendrikse, F. & Prins, M. H. (2005). Intraocular Pressure-Lowering Effects of All Commonly Used Glaucoma Drugs:: A Meta-analysis of Randomized Clinical Trials. Ophthalmology; 112(7), 1177-1185
[26] Liza-Sharmini, A. T., Yuen Shi Yin, N., Shi-Huang Lee, S., Jackson, A. L. & Stewart, W. C. (2009). Mean target intraocular pressure and progression rates in chronic angle-closure glaucoma. J Ocul Pharm Ther, 25(1), 71-76
[27] The AGIS Investigators. The Advanced Glaucoma Intervention Study (AGIS): 7. the relationship between control of intraocular pressure and visual field deterioration (2000). Am J Ophthalmol; 130:429C440.
[28] Schwenn, O., Heckmann, B., Guzy, C. & Miller, P. Long-term effect of latanoprost/timolol fixed combination in patients with glaucoma or ocular hypertension: A prospective, observational, noninterventional study. BMC ophthalmology, 10(1), 21.
[29] Ong, L. B., Liza-Sharmini, A. T., Chieng, L. L., Cheong, M. T., Vengadasalam, S. R., Shin, H. C. & Balaravi, P. (2005). The efficacy of timolol in gel-forming solution after morning or evening dosing in Asian glaucomatous patients. J Ocul Pharm Ther, 21(5), 388-394
[30] Shedden A,Laurence J, Tipping R; Timoptic XE 0.5% Study group(2001). Efficacy and tolerability of timolol maleate ophthalmic gel-forming solution versus timolol ophthalmic solution in adults with open-angle glaucoma or ocular hypertension: a six-month, double-masked, multicenter study. Clin Ther; 23: 440-450
[31] Zhao, J. L., Ge, J., Li, X. X., Li, Y. M., Sheng, Y. H., Sun, N. X., Sun, X. H., Yao, K. & Zhong, Z. Comparative efficacy and safety of the fixed versus unfixed combination of latanoprost and timolol in Chinese patients with open-angle glaucoma or ocular hypertension. BMC ophthalmology, 11(1), 23.
[32] Shedden AH, Laurence J, Barrish A, Olah TV (2001). Plasma timolol concentrations of timolol maleate: timolol gel forming solution (TIMOPTIC-XE®) once daily versus timolol maleate ophthalmic solution twice daily. Doc Ophthalmol; 103: 73-79.
[33] Hedman, K. & Larsson, L. I. (2002). The Effect of Latanoprost Compared with Timolol in African-American, Asian, Caucasian, and Mexican Open-Angle Glaucoma or Ocular Hypertensive Patients. Surv Ophthalmol, 47, S77-S89.
[34] Varma, R., Hwang, L. J., Grunden, J. W. & Bean, G. W. Using diurnal intraocular pressure fluctuation to assess the efficacy of fixed-combination latanoprost/timolol versus latanoprost or timolol monotherapy. Br J Ophthalmol, 94(1), 80.
[35] Nouri-Mahdavi, K., Hoffman, D., Coleman, A. L., Liu, G., Li, G., Gaasterland, D. & Caprioli, J. (2004). Predictive factors for glaucomatous visual field progression in the Advanced Glaucoma Intervention Study* 1. Ophthalmology, 111(9), 1627-1635
[36] Rulo AH, Greve EL, Geijssen HC, Hoyng PF (1996). Reduction of intraocular pressure with treatment of latanoprost once daily in patients with normal-pressure glaucoma. Ophthalmology; 103: 1276-1282
Cite This Article
  • APA Style

    Seyed Ali Asghar Mosavi, Ch’ng Tun Wang, Azhany Yaakub, Nik Azlan Zaid, Liza-Sharmini Ahmad Tajudin. (2012). Pressure lowering effect of fixed combination and unfixed- combination of latanoprost and timolol in Asian population. Clinical Medicine Research, 1(1), 7-12. https://doi.org/10.11648/j.cmr.20120101.12

    Copy | Download

    ACS Style

    Seyed Ali Asghar Mosavi; Ch’ng Tun Wang; Azhany Yaakub; Nik Azlan Zaid; Liza-Sharmini Ahmad Tajudin. Pressure lowering effect of fixed combination and unfixed- combination of latanoprost and timolol in Asian population. Clin. Med. Res. 2012, 1(1), 7-12. doi: 10.11648/j.cmr.20120101.12

    Copy | Download

    AMA Style

    Seyed Ali Asghar Mosavi, Ch’ng Tun Wang, Azhany Yaakub, Nik Azlan Zaid, Liza-Sharmini Ahmad Tajudin. Pressure lowering effect of fixed combination and unfixed- combination of latanoprost and timolol in Asian population. Clin Med Res. 2012;1(1):7-12. doi: 10.11648/j.cmr.20120101.12

    Copy | Download

  • @article{10.11648/j.cmr.20120101.12,
      author = {Seyed Ali Asghar Mosavi and Ch’ng Tun Wang and Azhany Yaakub and Nik Azlan Zaid and Liza-Sharmini Ahmad Tajudin},
      title = {Pressure lowering effect of fixed combination and unfixed- combination of latanoprost and timolol in Asian population},
      journal = {Clinical Medicine Research},
      volume = {1},
      number = {1},
      pages = {7-12},
      doi = {10.11648/j.cmr.20120101.12},
      url = {https://doi.org/10.11648/j.cmr.20120101.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20120101.12},
      abstract = {Introduction: Fixed combination of topical pressure lowering drugs such as latanoprost and timolol (FCLT) has been reported to improve adherence and persistence to medication for chronic disease such as glaucoma. However, its effectiveness has been reported to be less compared to unfixed combination of latanoprost and timolol (UFCLT). Objective: To compare the efficacy of FCLT and UFCLT in Malaysian population. Methods: A non randomized prospective cohort study was conducted from January 2006 to December 2010 involving primary open-angle glaucoma (POAG), ocular hypertension (OHT) and normal-tension glaucoma (NTG) patients who failed to achieve target pressure or demonstrated progression of the disease while on monotherapy treatment with topical timolol XE 0.5% in eye clinic of Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kelantan, Malaysia. A total of 120 glaucoma patients were recruited with 58 were prescribed FCLT and 62 were treated with UFCLT. UFCLT is combination of topical timolol XE 0.5% and latanoprost 0.005%. Intraocular pressure (IOP) was taken at baseline and 3, 6, 9, 12 months post treatment. Results: A total of 95 patients completed the 12 months follow up (47 in FCLT group and 48 in UFCLT). Mean age was 61.0 SD 14.5 years old. Majority of cases were POAG (79%), followed by NTG (12%) and OHT (9%). Mean baseline IOP was 23.9 SD 5.9 mmHg and 19.9 SD 5.6 mmHg in UFCLT and FCLT groups respectively. Mean IOP reduction between baseline and final measurement in UFCLT and FCLT groups were -8.1 mmHg vs.-3.6 mmHg respectively (p<0.001). Based on repeated measures analysis of variance (RM ANOVA) and repeated measures analysis of covariance (RM ANCOVA) model, there was significant difference between UFCLT and FCLT (p =0.002). Conclusions: Both UFCLT and FCLT provide pressure lowering effect in Malaysian population. UFCLT provides significant better pressure lowering effect than FCLT. FCLT provides less inter-visit pressure fluctuation.},
     year = {2012}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Pressure lowering effect of fixed combination and unfixed- combination of latanoprost and timolol in Asian population
    AU  - Seyed Ali Asghar Mosavi
    AU  - Ch’ng Tun Wang
    AU  - Azhany Yaakub
    AU  - Nik Azlan Zaid
    AU  - Liza-Sharmini Ahmad Tajudin
    Y1  - 2012/12/30
    PY  - 2012
    N1  - https://doi.org/10.11648/j.cmr.20120101.12
    DO  - 10.11648/j.cmr.20120101.12
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 7
    EP  - 12
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20120101.12
    AB  - Introduction: Fixed combination of topical pressure lowering drugs such as latanoprost and timolol (FCLT) has been reported to improve adherence and persistence to medication for chronic disease such as glaucoma. However, its effectiveness has been reported to be less compared to unfixed combination of latanoprost and timolol (UFCLT). Objective: To compare the efficacy of FCLT and UFCLT in Malaysian population. Methods: A non randomized prospective cohort study was conducted from January 2006 to December 2010 involving primary open-angle glaucoma (POAG), ocular hypertension (OHT) and normal-tension glaucoma (NTG) patients who failed to achieve target pressure or demonstrated progression of the disease while on monotherapy treatment with topical timolol XE 0.5% in eye clinic of Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kelantan, Malaysia. A total of 120 glaucoma patients were recruited with 58 were prescribed FCLT and 62 were treated with UFCLT. UFCLT is combination of topical timolol XE 0.5% and latanoprost 0.005%. Intraocular pressure (IOP) was taken at baseline and 3, 6, 9, 12 months post treatment. Results: A total of 95 patients completed the 12 months follow up (47 in FCLT group and 48 in UFCLT). Mean age was 61.0 SD 14.5 years old. Majority of cases were POAG (79%), followed by NTG (12%) and OHT (9%). Mean baseline IOP was 23.9 SD 5.9 mmHg and 19.9 SD 5.6 mmHg in UFCLT and FCLT groups respectively. Mean IOP reduction between baseline and final measurement in UFCLT and FCLT groups were -8.1 mmHg vs.-3.6 mmHg respectively (p<0.001). Based on repeated measures analysis of variance (RM ANOVA) and repeated measures analysis of covariance (RM ANCOVA) model, there was significant difference between UFCLT and FCLT (p =0.002). Conclusions: Both UFCLT and FCLT provide pressure lowering effect in Malaysian population. UFCLT provides significant better pressure lowering effect than FCLT. FCLT provides less inter-visit pressure fluctuation.
    VL  - 1
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Dept. Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Malaysia

  • Dept. Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Malaysia

  • Dept. Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Malaysia

  • Dept. Ophthalmology, Hospital Raja Perempuan Zainab II, Jalan Hospital, Kelantan, Malaysia

  • Dept. Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Malaysia

  • Sections