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Intraocular Pressure-Lowering Effects of Commonly Used Fixed-Combination Drugs with Timolol: A Systematic Review and Meta-Analysis

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  • Jin-Wei Cheng
  • Shi-Wei Cheng
  • Lian-Di Gao
  • Guo-Cai Lu
  • Rui-Li Wei

Abstract

Background: The first goal of medical therapy in glaucoma is to reduce intraocular pressure (IOP), and the fixed-combination medications are needed to achieve sufficiently low target IOP. The aim of this systematic review and meta-analysis is to evaluate IOP-lowering effect of the commonly used fixed-combination drugs containing 0.5% timolol. Methods: Pertinent publications were identified through systematic searches. Over 85% of the patients had to be diagnosed with primary open-angle glaucoma (POAG) or ocular hypertension (OHT). Forty-one randomized clinical trials were included in the meta-analysis. The main efficacy measures were the absolute and relative values of mean diurnal IOP reduction, and the highest and lowest IOP reductions on the diurnal IOP curve. The pooled 1- to 3-month IOP-lowering effects after a medicine-free washout period was calculated by performing meta-analysis using the random effects model, and relative treatment effects among different fixed combinations were assessed using a mixed-effects meta-regression model. Results: The relative reductions for mean diurnal IOP were 34.9% for travoprost/timolol, 34.3% for bimatoprost/timolol, 33.9% for latanoprost/timolol, 32.7% for brinzolamide/timolol, 29.9% for dorzolamide/timolol, and 28.1% for brimonidine/timolol. For the highest IOP decrease, relative reductions ranged from 31.3% for dorzolamide/timolol to 35.5% for travoprost/timolol; for the lowest IOP decrease, those varied from 25.9% for dorzolamide/timolol to 33.1% for bimatoprost/timolol. Both latanoprost/timolol and travoprost/timolol were more effective in lowering mean diurnal IOP than brimonidine/timolol (WMD: 5.9 and 7.0) and dorzolamide/timolol (WMD: 3.8 and 3.3). Conclusions: All six commonly used fixed-combination drugs containing timolol can effectively lower IOP in patients with POAG and OHT, and both latanoprost/timolol and travoprost/timolol might achieve better IOP-lowering effects among the six fixed-combination agents.

Suggested Citation

  • Jin-Wei Cheng & Shi-Wei Cheng & Lian-Di Gao & Guo-Cai Lu & Rui-Li Wei, 2012. "Intraocular Pressure-Lowering Effects of Commonly Used Fixed-Combination Drugs with Timolol: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-11, September.
    • Handle: RePEc:plo:pone00:0045079
    DOI: 10.1371/journal.pone.0045079
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    Cited by:

    1. Yi Xing & Lijuan Zhu & Ke Zhang & Shaohua Huang, 2020. "The efficacy of the fixed combination of latanoprost and timolol versus other fixed combinations for primary open-angle glaucoma and ocular hypertension: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-15, February.
    2. Miao He & Wei Wang & Wenyong Huang, 2013. "Efficacy and Tolerability of the Fixed Combinations Latanoprost/Timolol versus Dorzolamide/Timolol in Patients with Elevated Intraocular Pressure: A Meta-Analysis of Randomized Controlled Trials," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.

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