Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2014.55.468
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 reviews
Qëndresë Daka
; Department of Ophthalmology University Clinical Centre of Kosovo, Medical School, Prishtina University, Prishtina, Kosovo
Vladimir Trkulja
; Department of Pharmacology, University of Zagreb School of Medicine, Zagreb, Croatia
Sažetak
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
Ključne riječi
Hrčak ID:
129951
URI
Datum izdavanja:
15.10.2014.
Posjeta: 1.321 *