Three prostaglandins found equally effective as first-line treatment for glaucoma, ocular hypertension

This investigator-masked clinical trial compared the efficacy and tolerability of three topical prostaglandin analogs - bimatoprost, latanoprost and travoprost - in newly-diagnosed patients with ocular hypertension and open-angle glaucoma. The authors found that the three drugs are each potent and well-tolerated first-line treatments for these conditions, with similar tolerance and efficacy at six months.

They prospectively randomized 122 treatment-naive patients with ocular hypertension and open-angle glaucoma to treatment with bimatoprost 0.03% (Allergan, Inc.), latanoprost 0.005% (Pfizer Inc.) or travoprost 0.004% (Alcon, Inc.) eye drops. At two months, there was a significant difference between the treatment groups (P = 0.013), with bimatoprost achieving a greater reduction in IOP than the other two treatments. At six months, bimatoprost still had a greater effect on IOP, but this difference was not statistically significant (P = 0.13).

There was no significant difference in the tolerance profiles of the treatments. The number of patients who stopped using each of them was similar. Treatment intolerance was the most common reason for discontinuing bimatoprost, whereas more patients discontinued using latanoprost or travoprost due to lack of efficacy at lowering IOP.

The authors conclude that bimatoprost may be superior at lowering IOP in the short term, but whether this superiority is maintained at six months is unclear. They say that answering this definitely would require a larger study.