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Efficacy and tolerability of mono-compound topical treatments for reduction of intraocular pressure in patients with primary open angle glaucoma or ocular hypertension: an overview of reviews.

Abstract：

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.

journal_name

Croat Med J

journal_title

Croatian medical journal

authors

Daka Q,Trkulja V

doi

10.3325/cmj.2014.55.468

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

468-80

issue

eissn

0353-9504

issn

1332-8166

journal_volume

pub_type

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Efficacy and tolerability of mono-compound topical treatments for reduction of intraocular pressure in patients with primary open angle glaucoma or ocular hypertension: an overview of reviews.