Holmstrom Stefan, Buchholz Patricia, Walt John, Wickstrøm Jannie, Aagren Mark
Allergan Europe, Pforzheimer Str. 160, D-76275 Ettlingen, Germany.
Curr Med Res Opin. 2005 Nov;21(11):1875-83. doi: 10.1185/030079905X65600.
The objective of this review was to evaluate different measures of efficacy of the intraocular pressure (IOP) lowering lipid class agents bimatoprost, latanoprost and travoprost in the treatment of primary open angle glaucoma. Study arms of timolol in trials including the above mentioned lipid class drugs were also included.
MEDLINE and EMBASE were searched for randomized clinical trials including one or more of the lipid class drugs bimatoprost, latanoprost and travoprost. The study results were pooled, and the simple, weighted IOP-lowering efficacy was compared among the lipid class drugs and timolol, where data were available. Efficacy parameters were reviewed, including mean reduction of IOP and percentage of patients achieving different levels of IOP.
161 articles were identified of which 42 were included in the analysis. A total of 9295 patients participated in the included trials. Based on all studies, timolol on average had a weighted mean IOP reduction of 22.2%, while latanoprost, travoprost and bimatoprost had a weighted mean IOP reduction of 26.7%, 28.7% and 30.3%, respectively. Analysis of target achievement to various IOP levels shows that bimatoprost seems more efficacious than latanoprost. The direct comparisons (head-to-head studies) also show that bimatoprost is the most efficacious treatment, however it is not conclusive whether latanoprost or travoprost is better in reducing IOP.
This review shows that bimatoprost seems to be the most efficacious treatment in lowering IOP. Head-to-head studies confirm this.
本综述的目的是评估降低眼压的脂质类药物比马前列素、拉坦前列素和曲伏前列素在治疗原发性开角型青光眼方面的不同疗效指标。纳入了包含上述脂质类药物的试验中噻吗洛尔的研究组。
检索MEDLINE和EMBASE数据库，查找包含比马前列素、拉坦前列素和曲伏前列素中一种或多种脂质类药物的随机临床试验。汇总研究结果，并在有数据的情况下，比较脂质类药物和噻吗洛尔之间简单的加权眼压降低疗效。回顾疗效参数，包括眼压的平均降低值和达到不同眼压水平的患者百分比。
共识别出161篇文章，其中42篇纳入分析。共有9295名患者参与了纳入的试验。基于所有研究，噻吗洛尔平均加权眼压降低值为22.2%，而拉坦前列素、曲伏前列素和比马前列素的加权眼压平均降低值分别为26.7%、28.7%和30.3%。对达到不同眼压水平的目标达成情况分析表明，比马前列素似乎比拉坦前列素更有效。直接比较（头对头研究）也表明比马前列素是最有效的治疗方法，然而拉坦前列素或曲伏前列素在降低眼压方面哪个更好尚无定论。
本综述表明，比马前列素似乎是降低眼压最有效的治疗方法。头对头研究证实了这一点。
