Kampik Anselm, Arias-Puente Alfonso, O'Brart David P S, Vuori Marja-Liisa
Department of Ophthalmology, Ludwigs-Maximilians University, Munich, Germany.
J Glaucoma. 2002 Apr;11(2):90-6. doi: 10.1097/00061198-200204000-00003.
To compare the effect of treatment with latanoprost or brimonidine on intraocular pressure in patients with glaucoma or ocular hypertension and intraocular pressure inadequately controlled by monotherapy or dual therapy.
Three hundred seventy-nine patients with primary open-angle glaucoma or ocular hypertension were recruited for this 6-month prospective, randomized, observer-masked multicenter study involving 30 eye clinics. All patients were receiving monotherapy or dual therapy that did not adequately control intraocular pressure. After appropriate washout periods, patients were randomized to treatment with latanoprost once daily or brimonidine twice daily. The main outcome measure was change in mean diurnal intraocular pressure after 6 months of treatment compared with baseline.
Of the 379 randomized patients, 375 were included in the intent-to-treat analysis. From an overall baseline mean intraocular pressure of 25.0 mm Hg, latanoprost monotherapy reduced mean diurnal intraocular pressure by 7.1 +/- 3.3 mm Hg (mean +/- SD, P < 0.001), whereas brimonidine monotherapy yielded an intraocular-pressure reduction of 5.2 +/- 3.5 mm Hg (P < 0.001). This 1.9 mm Hg difference in intraocular-pressure reduction was significantly in favor of latanoprost (P < 0.001). Ocular allergy (P < 0.001) and systemic side effects (P = 0.005) were reported significantly less frequently by latanoprost-treated patients compared with brimonidine-treated patients.
Both latanoprost and brimonidine reduced intraocular pressure in patients with glaucoma or ocular hypertension after 6 months of treatment. However, latanoprost once daily was significantly more effective than brimonidine twice daily in reducing mean diurnal intraocular pressure. Latanoprost was better tolerated with less frequently occurring ocular allergy and systemic side effects.
比较拉坦前列素或溴莫尼定治疗对青光眼或高眼压症患者眼压的影响，这些患者的眼压经单一疗法或联合疗法控制不佳。
379例原发性开角型青光眼或高眼压症患者被纳入这项为期6个月的前瞻性、随机、观察者盲法多中心研究，该研究涉及30家眼科诊所。所有患者均接受未能充分控制眼压的单一疗法或联合疗法。经过适当的洗脱期后，患者被随机分为每日一次使用拉坦前列素治疗组或每日两次使用溴莫尼定治疗组。主要观察指标是治疗6个月后平均日间眼压与基线相比的变化。
在379例随机分组的患者中，375例被纳入意向性分析。从总体基线平均眼压25.0 mmHg开始，拉坦前列素单一疗法使平均日间眼压降低7.1±3.3 mmHg（平均值±标准差，P<0.001），而溴莫尼定单一疗法使眼压降低5.2±3.5 mmHg（P<0.001）。眼压降低的这1.9 mmHg差异显著有利于拉坦前列素（P<0.001）。与接受溴莫尼定治疗的患者相比，接受拉坦前列素治疗的患者眼部过敏（P<0.001）和全身副作用（P=0.005）的报告频率显著更低。
拉坦前列素和溴莫尼定在治疗6个月后均降低了青光眼或高眼压症患者的眼压。然而，每日一次的拉坦前列素在降低平均日间眼压方面显著比每日两次的溴莫尼定更有效。拉坦前列素耐受性更好，眼部过敏和全身副作用的发生率更低。
