Comparative effectiveness of glaucoma drops

Comparative effectiveness of glaucoma drops

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Background

Potency - Comparative effectiveness

Notes

• Estimated potency based primarily on Li T, Lindsley K, et al.  Additional comments from the various package inserts (clinical trial data) were also used.
• Medications containing brackets below indicate the mean reductions (95% credible intervals) in IOP in mmHg at 3 months - from Li T, Lindsley K, et al.

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Available Products in the U.S. Listed by the estimated Potency

Most potent to Least potent - Impact on intraocular pressure (IOP)

Rocklatan® (netarsudil and latanoprost)  [COMBINATION PRODUCT]

Combigan® (brimonidine tartrate/timolol maleate) [COMBINATION PRODUCT]

Cosopt® - Dorzolomide HCI & Timolol Maleate [COMBINATION PRODUCT]

Simbrinza® (brinzolamide/brimonidine tartrate) [COMBINATION PRODUCT]

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Latanoprostene bunod 0.024% (Vyzulta™)

Bimatoprost 0.01%, 0.03% (Lumigan®) [5.61]

Latanoprost 0.005% (Xalatan®) [4.85]

Travoprost 0.004% (Travatan® Z) [4.83]

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Levobunolol HCI ophthalmic solution, USP 0.25%, 0.5% (Betagan®) [4.51]

Tafluprost ophthalmic solution 0.0015% (PF) (Zioptan™) [4.37]

Timolol maleate ophthalmic solution 0.25%, 0.5%  [3.7]

Netarsudil 0.02% (Rhopressa®)

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Brimonidine tartrate ophthalmic solution 0.2%  [3.59]

Dorzolamide HCI 2% (Trusopt®) [2.49]

Brinzolamide ophthalmic suspension 1% (Azopt®) [2.42]

Betaxolol HCI 0.25%, 0.5% (Betoptic®) [2.24]

References Li T, Lindsley K, Rouse B, et al. Comparative Effectiveness of First-Line Medications for Primary Open-Angle Glaucoma: A Systematic Review and Network Meta-analysis. Ophthalmology. 2016;123(1):129-140. doi:10.1016/j.ophtha.2015.09.005 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695285/ Conclusions:   All active first-line drugs are effective compared to placebo in reducing IOP at 3 months. Bimatoprost, latanoprost, and travoprost are among the most efficacious drugs, although the within class differences were small and may not be clinically meaningful. All factors, including adverse effects, patient preferences, and cost should be considered in selecting a drug for a given patient. Fingeret M, Gaddie IB, Bloomenstein M. Latanoprostene bunod ophthalmic solution 0.024%: a new treatment option for open-angle glaucoma and ocular hypertension. Clin Exp Optom. 2019;102(6):541-550. doi:10.1111/cxo.12853. https://pubmed.ncbi.nlm.nih.gov/30614563/