Evaluation of efficacy of the fixed vs unfixed combination of latanoprost and timolol in patients of open-angle glaucoma and ocular hypertension insufficiently controlled on timolol and latanoprost monotherapy

Background: Glaucoma is a term describing a group of ocular disorders with multifactorial etiology united by a clinically characteristic intraocular pressure (IOP) associated optic neuropathy. Elevated IOP is identified as the only known risk factor which can be modified by anti-glaucomatous treatments. Patients who do not achieve target IOP levels with a single ocular hypotensive agent often are prescribed concomitant therapy with a medication that has a different mechanism of action. Aims and Objectives: The aim was to evaluate the efficacy of the fixed and unfixed combinations of latanoprost and timolol in patients of open-angle glaucoma and ocular hypertension (OH). Materials and Methods: A comparative randomized open-label trial was conducted on newly diagnosed patients of open-angle glaucoma and OH who were receiving either latanoprost 0.005% once daily or either timolol SR 0.5% once or twice daily in the preceding 4 weeks and whose IOP was not controlled with the prior monotherapy of latanoprost or timolol and remained ≥21 mmHg were included in the study. Patients were randomized to two groups to receive the following medication - Group I: Fixed combination eye drops of latanoprost (0.005%) and timolol SR (0.5%), once a day, in the dose of 1 drop at 9 LTFC and Group II: Unfixed combination of latanoprost (0.005%), once a day in the dose of 1 drop at 9 pm and timolol SR (0.5%), once a day in the dose of 1 drop at 9 am (LTuFC). Patients were evaluated at 0, 2, 4, 6, and 12 weeks for the assessment of IOP and Visual acuity. Results: Both LTFC (Group I) and LTuFC (Group II) caused a reduction in IOP which was statistically highly significant (P < 0.01) at all the intervals but on comparison both the groups affected the IOP in a similar fashion and demonstrated no difference statistically (P > 0.05). Conclusion: Both the regimens on comparison revealed similar efficacy thereby failing to prove superiority over each other. Thus, the clinicians have a wider choice of fixed or unfixed combinations of latanoprost and timolol, when monotherapy of either drug fails. [Natl J Physiol Pharm Pharmacol 2017; 7(8.000): 797-801]