Efficacy of brimonidine as replacement therapy in patients with open-angle glaucoma or ocular hypertension.

BACKGROUND

Patients with glaucoma or ocular hypertension may have inadequately controlled intraocular pressure (IOP) or experience adverse effects with their current medication regimens.

OBJECTIVE

This post hoc reanalysis determined the effectiveness and tolerability of brimonidine used as replacement therapy in a real-life clinical practice setting.

METHODS

In this multicenter, open-label, observational, 2-month study, 460 patients received brimonidine 0.2% as a 1:1 replacement for another antiglaucoma medication in their current regimen. Effectiveness was assessed by calculating the mean additional reduction in IOP from the treated baseline measurement (before the switch to brimonidine) to 2 months postbaseline, and by determining physicians' opinions of treatment effectiveness. Tolerability was determined based on quality-of-life assessments and recorded adverse events.

RESULTS

Overall, brimonidine replacement significantly reduced mean (+/- SEM) IOP by an additional 2.33 +/- 0.17 mm Hg (9.8% +/- 0.9%; P < 0.001). Significant additional reductions in IOP were seen when brimonidine replaced an agent used either as monotherapy or adjunctive therapy, regardless of the drug class of the agent replaced. However, particularly good hypotensive effectiveness and additional lowering of IOP were observed when brimonidine replaced certain medications, including latanoprost (12.44%; P < 0.003) and betaxolol (13.56%; P < 0.001) monotherapy, and latanoprost (16.08%; P < 0.010) adjunctive therapy. The effectiveness of brimonidine was rated as good or excellent by 92.4% of physicians. All quality-of-life variables remained favorable or improved throughout the study, and brimonidine treatment was well tolerated.

CONCLUSIONS

Brimonidine 0.2% used as a 1:1 replacement for monotherapy or adjunctive therapy with other antiglaucoma drugs significantly lowered IOP from that produced by previous therapy and was well tolerated. Brimonidine offers a useful treatment option in patients who require replacement therapy.