Efficacy and safety of bimatoprost versus latanoprost in the treatment of glaucoma：a meta-analysis / 中国药房

OBJECTIVE To compare the efficacy and safety of bimatoprost and latanoprost in the treatment of glaucoma， and to provide evidence-based reference for clinical rational drug use. METHODS PubMed， Embase， the Cochrane Library， China Biology Medicine disc， CNKI， Wanfang Data， and VIP databases were searched by computer to collect the randomized controlled trials （RCTs） about bimatoprost （trial group） versus latanoprost （control group） in the treatment of glaucoma from the inception to March 2022. After screening the literature and extracting the data， the qualities of the included literature were evaluated using the bias risk assessment tool recommended by the Cochrane system evaluator manual 5.1.0. Meta-analysis， sensitivity analysis and publication bias analysis were performed by using RevMan 5.4 and Stata 12 software. RESULTS A total of 2 181 patients were enrolled in 19 RCTs. Meta-analysis results showed that， the end point intraocular pressure reduction （IOPR） [MD＝0.89， 95%CI （0.53，1.25）， P＜0.000 01] of patients in trial group was significantly lower than control group， while the incidence of conjunctival congestion [RR＝1.89， 95%CI （1.59， 2.24）， P＜0.000 01] and eyelash growth [RR＝3.17， 95%CI （1.97，5.08）， P＜0.000 01] were significantly higher than control group. There was no significant difference in the incidence of eye irritation/foreign body sensation， pruritus， dry eye， eye inflammation， eye pain， visual impairment or iris/skin pigmentation between 2 groups （P＞0.05）. Results of subgroup analysis based on different medication time points showed that， the IOPR of patients in the trial group after 1， 3 and 6 months of treatment was significantly lower than control group （P＜0.05）. Results of sensitivity analysis showed that the result of this study was robust. The publication bias analysis showed that there was little possibility of publication bias in this study. CONCLUSIONS Compared with latanoprost， bimatoprost has more advantages in improving intraocular pressure， but the risk of conjunctival congestion and eyelash growth is higher than latanoprost.

Determination of five prostaglandin analogs in eyelash enhancing cosmetics by LC-MS/MS / 上海预防医学

Objective To determine bimatoprost， tafluprost ethyl amide， latanoprost， travoprost and tafluprost in eyelash enhancing cosmetics by establishing a LC-MS/MS method. Methods The samples were extracted with a 50% acetonitrile water solution. A salt mixture（4 g NaCl， 1 g MgSO4） was added to the solution to induce phase separation. After centrifugation and filtration， the analysis of five prostaglandin analogs was performed with an Agilent Poroshell 120 PFP-C18 （2.7 μm， 2.1 mm×100 mm） column， using 0.02% formic acid containing 5 mmol·L-1 Acetic acid amine and acetonitrile by gradient elution at a flow rate of 0.5 mL·min-1. The analytes were detected with electrospray ionization source in positive ion mode （ESI+） and multiple reaction monitoring （MRM）， and quantified by external standard curve. Results The results showed that it had a good linearity in the range of locatable ambit of concentration with correlation coefficients （r） larger than 0.999. The detection limit of five prostaglandin analogs （LOD） was 0.000 2‒1.5 μg·g-1. The spiked recoveries were 93.2% to 103.5% with a relative standard deviation （RSD） of 1.2% to 3.4%. Conclusion The method is simple， rapid and highly sensitive. It is suitable for the determination of five prostaglandin analogs in eyelash enhancing cosmetics.

Enoftalmia causada por uso tópico unilateral de Bimatoprost / Unilateral enophthalmos induced by the unilateral use of topical Bimatoprost

RESUMO O autor descreve o caso de uma paciente que apresenta o olho direito com o sulco palpebral profundo e enoftalmia deste lado, tratado durante uma década com Bimatoprost tópica. Concluem que os achados clínicos são provavelmente efeitos colaterais do medicamento.

ABSTRACT The author describes a case report of a patient with unilateral enophthalmia and deep palpebral sulcus probably induced by the topical use of Bimatoprost on the side of the collateral effects described.

Cost-minimization Analysis of Prostaglandins Drugs in the Treatment of Glaucoma / 中国药房

OBJECTIVE:To investigate the curative effect and economics of prostaglandins drugs in the treatment of glauco-ma,and to provide reference for clinical medication. METHODS:In retrospective study,a total of 790 glaucoma patients were di-vided into latanoprost group(62 cases),travoprost group(356 cases)and bimatoprost group(372 cases)according to therapy regi-men. They were given relevant medicine. Total effective rate of 3 groups were calculated,and the cost-minimization method was used for pharmacoeconomics evaluation. RESULTS:The total effective rate of 3 groups were 87.10%,84.27%,76.08% respective-ly,without statistical significance(P>0.05). The cost of them were 208.00 yuan,225.00 yuan and 173.00 yuan,and that of bima-toprost group was the lowest. The results of sensitivity analysis was in line with that of cost-minimization analysis. CONCLU-SIONS:For glaucoma,bimatoprost is more economical than latanoprost and travoprost.

Effect of Bimatoprost on the Permeability of Trabecular Meshwork Cell Monolayer

PURPOSE: To investigate the effects of bimatoprost on the permeability of cultured human trabecular meshwork cells (HTMC) monolayer. METHODS: HTMCs were cultured until confluency in the inner Transwell chamber and then exposed to benzalkonium chloride, brimonidine, latanoprost or bimatoprost for 1 week. Carboxyfluorescein permeability through the HTMC monolayer was measured using a spectrofluorometer after 2 hours in the outer chamber. Cellular viability was assessed using the MTT assay. RESULTS: Each drug diluted at 1/1000X did not affect the cellular survival (p > 0.05). Brimonidine, latanoprost and bimatoprost did not affect the carboxyfluorescein permeability through the HTMC monolayer (p > 0.05). The carboxyfluorescein permeability was not different between latanoptost and bimatoprost after 1 week of exposure (p > 0.05). CONCLUSIONS: Bimatoprost, a drug known to increase trabecular outflow, does not affect the carboxyfluorescein permeability through the HTMC monolayer. Thus, the effect on the trabecular outflow of bimatoprost may not be significant.

Diurnal Intraocular Pressure with Bimatoprost/Timolol Fixed Combination versus Latanoprost/Timolol Fixed Combination in Healthy Subjects

PURPOSE: To evaluate the effects of a bimatoprost/timolol fixed combination (BTFC) and a latanoprost/timolol fixed combination (LTFC) on diurnal intraocular pressure (IOP) and anterior ocular parameters in healthy subjects. METHODS: We enrolled 58 healthy subjects in this prospective clinical study. Thirty subjects were treated with BTFC and 28 subjects were treated with LTFC. IOP was measured every 2 hours except from 01:00 and 05:00. Axial length, corneal curvature, and anterior chamber depth were obtained using the IOL master at baseline and 24 hours later. Adverse events were assessed by patient interview and by slit lamp examination. RESULTS: The largest difference in IOP between treated and untreated eyes 8 hours after instillation was 1.67 mmHg in the BTFC group (p < 0.001). The largest difference in IOP between treated and untreated eyes 10 hours after instillation was 1.93 mmHg in the LTFC group (p < 0.001). For anterior ocular parameters such as axial length, corneal curvature, anterior chamber depth at baseline and 24 hours after instillation, there were no significant differences between the baseline and 24-hour values in either the BTFC or LTFC group. The most frequently occurring adverse event was conjunctival hyperemia, which was found in 33.3% (n = 10) of the BTFC group and 25.0% (n = 7) of the LTFC group (p = 0.486). CONCLUSIONS: BTFC and LTFC provided a significant reduction in IOP from baseline without changing any anterior ocular parameters. Our results provide a reference for monocular trials to assess the effect of eye drops in a clinical condition.

Diurnal Intraocular Pressure with Bimatoprost/Timolol Fixed Combination versus Latanoprost/Timolol Fixed Combination in Healthy Subjects

PURPOSE: To evaluate the effects of a bimatoprost/timolol fixed combination (BTFC) and a latanoprost/timolol fixed combination (LTFC) on diurnal intraocular pressure (IOP) and anterior ocular parameters in healthy subjects. METHODS: We enrolled 58 healthy subjects in this prospective clinical study. Thirty subjects were treated with BTFC and 28 subjects were treated with LTFC. IOP was measured every 2 hours except from 01:00 and 05:00. Axial length, corneal curvature, and anterior chamber depth were obtained using the IOL master at baseline and 24 hours later. Adverse events were assessed by patient interview and by slit lamp examination. RESULTS: The largest difference in IOP between treated and untreated eyes 8 hours after instillation was 1.67 mmHg in the BTFC group (p < 0.001). The largest difference in IOP between treated and untreated eyes 10 hours after instillation was 1.93 mmHg in the LTFC group (p < 0.001). For anterior ocular parameters such as axial length, corneal curvature, anterior chamber depth at baseline and 24 hours after instillation, there were no significant differences between the baseline and 24-hour values in either the BTFC or LTFC group. The most frequently occurring adverse event was conjunctival hyperemia, which was found in 33.3% (n = 10) of the BTFC group and 25.0% (n = 7) of the LTFC group (p = 0.486). CONCLUSIONS: BTFC and LTFC provided a significant reduction in IOP from baseline without changing any anterior ocular parameters. Our results provide a reference for monocular trials to assess the effect of eye drops in a clinical condition.

Timolol and Bimatoprost in Primary Open Angle Glaucoma-A Comparative Study.

The present study evaluated safety and intraocular pressure lowering efficacy of ocular antiglaucoma drugs timolol maleate 0.5% and bimatoprost 0.03% as monotherapy for 12 weeks on 50 patients divided in two groups with established primary open angle glaucoma. Higher incidence (72%) was found in patients aged 50 years and above and 60% were males. In both the groups, significant fall in mean intraocular pressure was observed. The mean reduction in intraocular pressure was 29.9% for timolol group and 36% for bimatoprost group. Bimatoprost o.d. was statistically and clinically superior to timolol b.d. in lowering intraocular pressure.

Efficacy of bimatoprost 0.03% in reducing intraocular pressure in patients with 360° synechial angle-closure glaucoma: A preliminary study.

Context: Peripheral anterior synechiae (PAS; synechiae anterior to functional trabecular meshwork) formation in primary angle-closure glaucoma (PACG) hampers access to uveoscleral outflow. Thus, the role of bimatoprost in such patients with 360° synechiae was evaluated. Aims: To assess efficacy and safety profile of bimatoprost 0.03% in lowering intraocular pressure (IOP) in 360° synechial angle-closure glaucoma patients. Settings and Design: This was a prospective, non-randomized, non-comparative, selective analysis, single-center pilot study. Materials and Methods: A total of 23 eyes of 20 Indian chronic angle-closure glaucoma (CACG) patients with IOP greater than 21 mmHg, 360° PAS and no visual potential in the study eye underwent detailed eye examination. Baseline IOP was measured and YAG peripheral iridotomy was performed for complete angle-closure reconfirmation. Bimatoprost 0.03% was administered for 8 weeks as once-daily evening dose. IOP reduction within treatment group was determined with “paired t-test”. Results: The mean reduction in IOP from baseline to 8 weeks of bimatoprost therapy was 15.3 ± 9.5 mmHg (P < 0.001). The most commonly observed adverse event was conjunctival hyperemia (35%). Bimatoprost was well tolerated in the study. Conclusions: In this study, exclusively involving patients with 360° synechial angle-closure glaucoma and no visual potential, bimatoprost 0.03% treatment demonstrated a statistically significant IOP reduction. Hence, it can be inferred that bimatoprost 0.03% is an efficacious treatment modality in this subgroup of patients for reducing IOP.

A meta-analysis of therapy comparison between bimatoprost and timolol in ocular hypertention eye / 眼科研究

Objective Many researches have demonstrated the lowing-intraocular pressure(IOP) effects of bimatoprost and timolol.However,no powerful evidence showed which drug has the better efficacy.This study was to perform a meta-analysis to evaluate the efficacy and tolerability of bimatoprost compared with latanoprost in lowing IOP.MethodsThis was a evidence-based medicine science study.Pertinent studies were identified through searches of PubMed,EMBASE,the Cochrane Liberary Controlled Trials Register and Chinese Biomedicine Database using the terms of timolol,blocardren,temserin,timoptic,bimatoprost,lumigan.The intensive searching by hand and up to October 1,2008 was also designed.ResultsSix randomized and controlled studies enrolling a total of 2 094 patients were included in the meta-analysis and three clinical indexes were analyzed.Bimatoprost was associated with greater decline value from baseline IOP in comparison with timolol(P＜0.01) with a weight mean difference -2.04 at final point(95% CI:-2.44 to -1.64).Numerically greater proportions of bimatoprost patients than timolol patients achieved the target IOP at 3 months(from 3 literature) and ＞6 months(from 2 literature) with a pooled RR of 1.87(95% CI:1.45 to 2.41),1.60(95% CI:1.36 to 1.90) (P＜0.01),respectively.Bimatoprost showed a more frequencies in the adverse effects such as conjunctival hyperemia and eyelash growth than timolol with an RR of 4.18 (95% CI:2.89 to 6.05),9.40 (95% CI:5.62 to 15.71).No obvious drug-related side effect was found from literature analysis included both drugs.Conclusion Searched literature offers grade A of evidences for the comparison clinical evaluation of therapy efficacy between bimatoprost and timolol in lowing IOP.Bimatoprost has a better efficacy in lowering IOP and reaching comparable proportions of patients with target IOP than timolol.Both agents are well tolerated.

Cost-effectiveness of latanoprost, travoprost and bimatoprost for the treatment of glaucoma in Norway, Sweden and Denmark, using a decision-analytic health economic model / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the cost-effectiveness of latanoprost, travoprost and bimatoprost monotherapy in open angle glaucoma in Norway, Sweden and Denmark(Scandinavia). METHODS: A Markov decision-analytic health economic model was developed to estimate the comparative cost-effectiveness of prostaglandin analogs. Health states were stable and progressed glaucoma. Transition probabilities for both primary open angle and exfoliation glaucoma were populated with data from published medical literature. Clinical practice patterns were derived from surveys obtained from 45 ophthalmologists dispersed throughout each country. Specific unit costs for each country were used for medications, clinic visits, diagnostics and therapies. Quality-of-life weights were assigned for visual acuity from 0. 50- 0. 84. The time horizon was five years. All analyses were from a payer perspective and cost results were discounted at 3% per annum.RESULTS: Latanoprost was less expensive and more effective than bimatoprost and travoprost in both Norway and Sweden. Latanoprost was up to 4% less expensive in Sweden and Norway and the costs of all three medicines were within 1.5% of each other in Denmark. In Denmark bimatoprost dominated travoprost and was slightly less expensive than latanoprost while latanoprost was more effective than bimatoprost or travoprost. Effectiveness was within a narrow range for all products in each country.CONCLUSION: Latanoprost provides a cost-effective alternative to other available prostaglandin analogs in Scandinavia.

Two Cases of Deepening of the Upper Lid Sulcus from Topical Bimatoprost Therapy

PURPOSE: To report two cases of deepening of the upper lid sulcus following bimatoprost. METHODS: A 54-year-old woman who used bimatoprost for one week and a 70-year-old woman who used bimatoprost for 4 months developed deep lid sulcus. Both were using bimatoprost for glaucoma treatment. RESULTS: Both patients also showed improvement of dermatochalasis and widening of the palpebral fissure. One week after discontinuing bimatoprost, the lid sulcus of the 54-year-old returned to baseline and exophthalmometry was unchanged. The orbital CT of the 70-year-old was normal. She did not complain about deepening of the lid sulcus, and she has not discontinued treatment due to this adverse effect.

Clinical Course of Bimatoprost-induced Periocular Skin Hyperpigmentation after Stopping Bimatoprost Treatment

PURPOSE: To evaluate the demographic and clinical characteristics of bimatoprost-induced periocular skin hyperpigmentation. METHODS: The chart analyses of 16 patients in whom cosmetically noticeable periocular skin hyperpigmentation developed after starting bimatoprost therapy were reviewed. Data collated included age, medication history, dates of starting and stopping bimatoprost treatment, and the subjective assessment of the periocular hyperpigmentation at initial detection as well as follow-up visits. Periocular hyperpigmentation was graded using an arbitrary scale from 0 to 3. The number of days to the onset of hyperpigmentation and to pigment resolution was determined and their associations to demographic and other clinical parameters were analyzed. RESULTS: Patients had variable grades of periocular hyperpigmentation at presentation (mean, 1.53+/-0.66). Bimatoprost-induced periocular hyperpigmentation appeared 1-10 (mean, 4.3+/-2.6) months after initiation of bimatoprost therapy. Resolution of skin hyperpigmentation was noted 2-10(mean 6.8+/-1.9) months after stopping bimatoprost treatment. There was a minor correlation(R=+0.19) between the number of days to resolution of hyperpigmentation and the number of days when bimatoprost was used. At 12 months after stopping bimatoprost treatment, 12 of the 13 patients had complete resolution of periocular hyperpigmentation. However, weak hyperpigmentation remained in one patient. CONCLUSIONS: Bimatoprost-induced hyperpigmentation is benign and reversible.

The Short Term Effects of Bimatoprost on Optic Nerve Head and Peripapillary Retinal Blood Flow

PURPOSE: To demonstrate the effects of bimatoprost on the optic nerve head (ONH) and peripapillary retinal blood flow. METHODS: Sixteen healthy volunteers were recruited. In a randomized, double-blind design, one eye received a drop of bimatoprost and the other eye a drop of placebo. ONH and peripapillary retinal blood flow parameters (flow, volume, velocity) were measured with HRF before, and at 1, 6 and 24 hours after eyedrops and blood pressure (BP), heart rate (HR), and intraocular pressure (IOP) were recorded. RESULTS: The 16 subjects comprised 13 males and 3 females with a mean age of 27.3 +/- 2.4 years. IOP decreased significantly in the bimatoprost-treated eyes at 1, 6 and 24 hours after eyedrops (p<0.05). BP and HR were unchanged after bimatoprost eyedrops. The flow was significantly higher in the temporal peripapillary retina in the bimatoprost-treated eyes 1 hour after eyedrops and the velocity was also higher 6 hours after eyedrops at the same location. At the optic disc, there was a significant increase of the volume in the bimatoprost group 1 hour after eyedrops. There was no significant decrease of HRF parameters in the bimatoprost-treated eyes. CONCLUSIONS: These results suggest that bimatoprost does not have any adverse effect on ONH or peripapillary retinal blood flow.