Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: A meta-analysis

Oghenowede Eyawo, Jean Nachega, Pierre Lefebvre, David Meyer, Beth Rachlis, Chia Wen Lee, Steven Kelly, Edward Mills

Research output: Contribution to journalArticle

Abstract

Background: First-line therapy for primary open-angle glaucoma and ocular hypertension generally involves prostaglandin analogue therapy. The relative efficacy of differing prostaglandin therapy is disputed. Methods: A meta-analysis was conducted of head-to-head randomized trials of prostaglandin therapies. We included randomized trials assessing head-to-head evaluations of prostaglandin analogues travoprost, latanoprost and bimatoprost in patients with predominantly primary open-angle glaucoma or ocular hypertension. Findings were interpreted in light of equivalence margins. Results: Our search identified 16 eligible trials, of which 15 were included in the meta-analysis. Trials were, in general, poorly reported. We pooled 9 trials assessing IOP-lowering effects of travoprost vs latanoprost (total n = 1098, weighted mean difference [WMD], -0.24 mmHg, 95% CI, -0.87 to 0.38, P = 0.45, I2 = 56%, 95% CI, 0 to 0.77, heterogeneity P = 0.01). Eight trials assessed travoprost vs bimatoprost (total n = 714, WMD, 0.88 mmHg, 95% CI, 0.13 to 1.63, P = 0.02, I2 = 56%, 95% CI, 0% to 78%, heterogeneity P = 0.02). And 8 trials assessed latanoprost vs bimatoprost (total n = 943, WMD, 0.73 mmHg, 95% CI, 0.10 to 1.37, P = 0.02, I2 = 47%, 95% CI, 0% to 74%, heterogeneity P = 0.06). Travoprost was associated with greater incidence of conjunctival hyperemia than latanoprost (RR 5.71, 95% CI, 1.81 to 18.02, P ≤ 0.001, I2 = 97%, 95% CI, 95 to 98, P ≤ 0.001). Five trials assessing latanoprost and bimatoprost revealed an elevated risk of conjunctival hyperemia with bimatoprost (RR 1.59, 95% CI, 1.02 to 2.48, P = 0.04, I2 = 76%, 95% CI, 16 to 88, P = 0.002). Conclusion: Randomized head-to-head evaluations of prostaglandin therapy demonstrate similar efficacy effects, but differing hyperemia effects.

Original languageEnglish (US)
Pages (from-to)447-456
Number of pages10
JournalClinical Ophthalmology
Volume3
Issue number1
StatePublished - 2009

Fingerprint

latanoprost
Synthetic Prostaglandins
Ocular Hypertension
Meta-Analysis
Hyperemia
Safety
Prostaglandins
Therapeutics
Bimatoprost
Primary Open Angle Glaucoma
Travoprost

Keywords

  • Bimatoprost
  • Latanoprost
  • Ocular hypertension
  • Primary open-angle glaucoma
  • Prostaglandin analogues
  • Travoprost

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Eyawo, O., Nachega, J., Lefebvre, P., Meyer, D., Rachlis, B., Lee, C. W., ... Mills, E. (2009). Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: A meta-analysis. Clinical Ophthalmology, 3(1), 447-456.

Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension : A meta-analysis. / Eyawo, Oghenowede; Nachega, Jean; Lefebvre, Pierre; Meyer, David; Rachlis, Beth; Lee, Chia Wen; Kelly, Steven; Mills, Edward.

In: Clinical Ophthalmology, Vol. 3, No. 1, 2009, p. 447-456.

Research output: Contribution to journalArticle

Eyawo, O, Nachega, J, Lefebvre, P, Meyer, D, Rachlis, B, Lee, CW, Kelly, S & Mills, E 2009, 'Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: A meta-analysis', Clinical Ophthalmology, vol. 3, no. 1, pp. 447-456.
Eyawo, Oghenowede ; Nachega, Jean ; Lefebvre, Pierre ; Meyer, David ; Rachlis, Beth ; Lee, Chia Wen ; Kelly, Steven ; Mills, Edward. / Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension : A meta-analysis. In: Clinical Ophthalmology. 2009 ; Vol. 3, No. 1. pp. 447-456.
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abstract = "Background: First-line therapy for primary open-angle glaucoma and ocular hypertension generally involves prostaglandin analogue therapy. The relative efficacy of differing prostaglandin therapy is disputed. Methods: A meta-analysis was conducted of head-to-head randomized trials of prostaglandin therapies. We included randomized trials assessing head-to-head evaluations of prostaglandin analogues travoprost, latanoprost and bimatoprost in patients with predominantly primary open-angle glaucoma or ocular hypertension. Findings were interpreted in light of equivalence margins. Results: Our search identified 16 eligible trials, of which 15 were included in the meta-analysis. Trials were, in general, poorly reported. We pooled 9 trials assessing IOP-lowering effects of travoprost vs latanoprost (total n = 1098, weighted mean difference [WMD], -0.24 mmHg, 95{\%} CI, -0.87 to 0.38, P = 0.45, I2 = 56{\%}, 95{\%} CI, 0 to 0.77, heterogeneity P = 0.01). Eight trials assessed travoprost vs bimatoprost (total n = 714, WMD, 0.88 mmHg, 95{\%} CI, 0.13 to 1.63, P = 0.02, I2 = 56{\%}, 95{\%} CI, 0{\%} to 78{\%}, heterogeneity P = 0.02). And 8 trials assessed latanoprost vs bimatoprost (total n = 943, WMD, 0.73 mmHg, 95{\%} CI, 0.10 to 1.37, P = 0.02, I2 = 47{\%}, 95{\%} CI, 0{\%} to 74{\%}, heterogeneity P = 0.06). Travoprost was associated with greater incidence of conjunctival hyperemia than latanoprost (RR 5.71, 95{\%} CI, 1.81 to 18.02, P ≤ 0.001, I2 = 97{\%}, 95{\%} CI, 95 to 98, P ≤ 0.001). Five trials assessing latanoprost and bimatoprost revealed an elevated risk of conjunctival hyperemia with bimatoprost (RR 1.59, 95{\%} CI, 1.02 to 2.48, P = 0.04, I2 = 76{\%}, 95{\%} CI, 16 to 88, P = 0.002). Conclusion: Randomized head-to-head evaluations of prostaglandin therapy demonstrate similar efficacy effects, but differing hyperemia effects.",
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T2 - A meta-analysis

AU - Eyawo, Oghenowede

AU - Nachega, Jean

AU - Lefebvre, Pierre

AU - Meyer, David

AU - Rachlis, Beth

AU - Lee, Chia Wen

AU - Kelly, Steven

AU - Mills, Edward

PY - 2009

Y1 - 2009

N2 - Background: First-line therapy for primary open-angle glaucoma and ocular hypertension generally involves prostaglandin analogue therapy. The relative efficacy of differing prostaglandin therapy is disputed. Methods: A meta-analysis was conducted of head-to-head randomized trials of prostaglandin therapies. We included randomized trials assessing head-to-head evaluations of prostaglandin analogues travoprost, latanoprost and bimatoprost in patients with predominantly primary open-angle glaucoma or ocular hypertension. Findings were interpreted in light of equivalence margins. Results: Our search identified 16 eligible trials, of which 15 were included in the meta-analysis. Trials were, in general, poorly reported. We pooled 9 trials assessing IOP-lowering effects of travoprost vs latanoprost (total n = 1098, weighted mean difference [WMD], -0.24 mmHg, 95% CI, -0.87 to 0.38, P = 0.45, I2 = 56%, 95% CI, 0 to 0.77, heterogeneity P = 0.01). Eight trials assessed travoprost vs bimatoprost (total n = 714, WMD, 0.88 mmHg, 95% CI, 0.13 to 1.63, P = 0.02, I2 = 56%, 95% CI, 0% to 78%, heterogeneity P = 0.02). And 8 trials assessed latanoprost vs bimatoprost (total n = 943, WMD, 0.73 mmHg, 95% CI, 0.10 to 1.37, P = 0.02, I2 = 47%, 95% CI, 0% to 74%, heterogeneity P = 0.06). Travoprost was associated with greater incidence of conjunctival hyperemia than latanoprost (RR 5.71, 95% CI, 1.81 to 18.02, P ≤ 0.001, I2 = 97%, 95% CI, 95 to 98, P ≤ 0.001). Five trials assessing latanoprost and bimatoprost revealed an elevated risk of conjunctival hyperemia with bimatoprost (RR 1.59, 95% CI, 1.02 to 2.48, P = 0.04, I2 = 76%, 95% CI, 16 to 88, P = 0.002). Conclusion: Randomized head-to-head evaluations of prostaglandin therapy demonstrate similar efficacy effects, but differing hyperemia effects.

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