Efficacy and tolerability of monocompound topical treatments for reduction of intraocular pressure in patients with primary open angle glaucoma or ocular hypertension: an overview of reviewsReport as inadecuate




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Croatian medical journal, Vol.55 No.5 October 2014. -

Aim To evaluate the existing evidence on relative efficacy

and tolerability of topical mono-compound intraocular

pressure IOP-lowering drugs in treatment of primary open

angle glaucoma POAG and ocular hypertension OHT.

Methods In this systematic review of systematic reviews-

meta-analyses of randomized controlled trials a thorough

and sensitive search of PubMed, Embase and Cochrane

Databases was performed. Individual study methodological

quality and quality of evidence were assessed using

the AMSTAR checklist and the GRADE system, respectively.

The relationships between individual drugs were evaluated

based on the best available evidence.

Results Of the 133 initial non-duplicate records, 16 studies

met the inclusion criteria. Five achieved an overall

-moderate- none achieved -high- quality of evidence and

evaluated prostaglandin analogues PGAs – latanoprost,

travoprost, and bimatoprost; timolol; -other beta-blockers;-

carbonic anhydrase inhibitors CAI as a group or dorzolamide

separately; and brimonidine. -Moderate quality- refers

to efficacy and incidence of conjunctival hyperemia.

Quality of evidence regarding other tolerability aspects was

low. PGAs should be considered equivalent regarding efficacy,

but latanoprost was relevantly better tolerated than

the other two. Non-PGA compounds did not relevantly differ

between each other in either efficacy or safety. Timolol

and brimonidine were relevantly less effective than all PGAs.

The same was true for CAI vs bimatoprost. Regarding tolerability,

timolol was superior to all PGAs and brimonidine and

CAI were superior to bimatoprost.

Conclusion No high quality evidence on relative efficacy

and tolerability of the most commonly used mono-compound

IOP-lowering drugs for POAG-OHT exists. Moderate

quality evidence indicates latanoprost as a treatment with

the most favorable trade-off between benefits and harms



Author: Qëndresë Daka - ; Department of Ophthalmology University Clinical Centre of Kosovo, Medical School, Prishtina University, Prish

Source: http://hrcak.srce.hr/



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