Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
PLoS One. 2020 Feb 27;15(2):e0229682. doi: 10.1371/journal.pone.0229682. eCollection 2020.
Fixed-combination (FC) therapy is used in primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients who require more than one medication to reach their target intraocular pressure (IOP). Currently, there are several FC therapies available for the treatment of glaucoma. The FC of latanoprost/timolol (LTFC) is a commonly used FC. Here, we conducted systematic review to compare the IOP-lowering effects of LTFC with other FCs for patients with POAG and OHT.
We searched PubMed, EMBASE, the Cochrane Library, and Web of Science for randomized-controlled clinical trials and cross-over studies. The outcomes were mean IOP and IOP fluctuation after one month of treatment. Meta-analysis was carried out using RevMan (version 5.1) software. After conducting meta-analyses, we rated the quality of each meta-analysis as high, moderate, low, or very low using the "GRADE" system.
We included 16 trials in this meta-analysis. Moderate-quality meta-analysis showed that LTFC had a comparable mean IOP to that of a fixed combination of travoprost and timolol (TTFC) [mean difference (MD): 0.07 mmHg] and a fixed combination of dorzolamide and timolol (DTFC) [MD: -0.31 mmHg], and it also had a comparable IOP-fluctuation effect compared to that of TTFC [MD: 0.13 mm Hg] and DTFC [MD: 0.25 mmHg]. Compared to the fixed combination of bimatoprost and timolol (BiTFC), moderate-quality evidence showed a higher mean IOP in the LTFC group [MD 0.76 mmHg], whereas low-quality meta-analysis showed higher IOP fluctuation [MD 1.09 mmHg] in the LTFC group.
LTFC is as effective as TTFC and DTFC, but worse than BiTFC in controlling mean IOP and IOP fluctuation for POAG or OHT patients. The quality of our meta-analyses was assessed as moderate, with the exception of one low-quality analysis that compared the IOP fluctuation of LTFC and BiTFC.
固定剂量联合（FC）疗法用于需要使用多种药物才能达到目标眼内压（IOP）的原发性开角型青光眼（POAG）和高眼压症（OHT）患者。目前，有几种 FC 疗法可用于治疗青光眼。拉坦前列素/噻吗洛尔（LTFC）的 FC 是一种常用的 FC。在这里，我们进行了系统评价，以比较 LTFC 与其他 FC 治疗 POAG 和 OHT 患者的降 IOP 效果。
我们在 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 中搜索了随机对照临床试验和交叉研究。结果是治疗一个月后的平均 IOP 和 IOP 波动。使用 RevMan（版本 5.1）软件进行荟萃分析。进行荟萃分析后，我们使用“GRADE”系统将每个荟萃分析的质量评为高、中、低或极低。
我们将 16 项试验纳入本荟萃分析。中度质量荟萃分析显示，LTFC 的平均 IOP 与曲伏前列素/噻吗洛尔（TTFC）的固定组合相当[平均差（MD）：0.07mmHg]，与多佐胺/噻吗洛尔（DTFC）的固定组合也相当[MD：-0.31mmHg]，与 TTFC 的 IOP 波动效应也相当[MD：0.13mmHg]，与 DTFC 的 IOP 波动效应也相当[MD：0.25mmHg]。与比马前列素/噻吗洛尔（BiTFC）的固定组合相比，中度质量证据表明 LTFC 组的平均 IOP 更高[MD 0.76mmHg]，而低质量荟萃分析表明 LTFC 组的 IOP 波动更高[MD 1.09mmHg]。
LTFC 与 TTFC 和 DTFC 一样有效，但在控制 POAG 或 OHT 患者的平均 IOP 和 IOP 波动方面不如 BiTFC。我们的荟萃分析质量被评估为中度，除了一项比较 LTFC 和 BiTFC 的 IOP 波动的低质量分析外。
