Comparison of the efficacy and safety of bimatoprost and timolol for treatment of chronic angle closure glaucoma

Abstract

Aim: To compare the efficacy, safety, and tolerability of bimatoprost 0.03% once daily with timolol 0.5% twice daily for patients with chronic angle closure glaucoma. Methods: In this multicentre double-masked randomised comparative trial conducted in Thailand, India, and The Philippines, patients with chronic angle closure glaucoma who had previously undergone laser peripheral iridotomy were treated with bimatoprost (n = 107) or timolol (n = 105) for 3 months. Patients were assessed at baseline, 2 weeks, 6 weeks, and 3 months. The primary outcome measures were the mean percentage change in intraocular pressure from baseline (efficacy) and the number and type of adverse events (safety and tolerability). Results: The mean total percentage decrease in intraocular pressure was significantly greater for the bimatoprost group than the timolol group at 2 weeks (30.6% vs 19.2%; p < 0.001), 6 weeks (29.7% vs 18.8%; p < 0.001), and 3 months (28.3% vs 18.4%; p < 0.001). The reduction in mean intraocular pressure 3 months from baseline was greater for the bimatoprost group than the timolol group (mean difference, -2.49 mm Hg; 95%confidence interval, -3.79 to -1.19 mm Hg). Conjunctival hyperaemia was the most frequently reported adverse event. There was no significant difference in the number of patients in each treatment group who withdrew because of an adverse event. Conclusions: Bimatoprost once daily was more effective than timolol for lowering intraocular pressure in patients with chronic angle closure glaucoma. Both bimatoprost and timolol were well tolerated, with few systemic adverse events reported. © 2007 Scientific Communications International Limited.