Combination therapy effective for patients receiving multiple and monotherapy glaucoma regimens

A combination anti-glaucoma drug that includes brimonidine tartrate ophthalmic solution 0.2% and timolol ophthalmic solution 0.5% (Combigan, Allergan) has a significant impact on the IOP of most patients regardless of gender and whether they are undergoing multiple or monotherapy for glaucoma, said Saad Younis, MD, from West Middlesex University and Ashford Hospital, Middlesex, United Kingdom.

"Patients requiring multiple ocular antihypertensive drugs to control IOP may benefit from fixed combinations that offer reduced exposure to the potentially toxic effects of the preservative benzalkonium chloride, removal of the risk of washout of the first instilled medication, and improved chances of patient compliance with the prescribed regimen," Dr. Younis explained.

Dr. Younis conducted this study to investigate the ocular hypotensive effect of the combination anti-glaucoma drug and evaluate the medication's effect on men and women. Glaucoma patients receiving treatment and exhibiting visual field or progressive IOP damage were included. Patients who needed a change in medication because of adverse events were excluded.

Nineteen women and 18 men were included (mean age of women, 68.5; mean age of men, 66.5 years). Twenty patients had been treated with monotherapy before they received the combination anti-glaucoma drug; 17 patients had been on multiple therapy regimens. The mean baseline IOP was 24.2 and 25.6 mm Hg in women and men, respectively. Eight patients left the study (five because of an allergic reaction to the combination anti-glaucoma drug and three because of insufficient IOP control). No systemic side effects developed.

Dr. Younis reported that the mean IOP reductions in all women were 4.13 ± 3.71 mm Hg and 5.23 ± 3.39 mm Hg, when patient withdrawals were excluded from analysis. The mean IOP decreases in all men were 4.06 ± 3.9 mm Hg and 5.21 ± 3.66 mm Hg when patient withdrawals were excluded. Overall the mean IOP reduction after the addition of the combination anti-glaucoma drug in all patients was 4.09 ± 3.75 mm Hg. When patient withdrawals were excluded the mean IOP in all patients was 5.22 ± 3.46 mm Hg.

"This study indicated that [the combination anti-glaucoma drug] has a clinically significant impact on the IOP of most patients whether male or female and whether they are on multiple or monotherapy for glaucoma," Dr. Younis said.