Role of fixed-combination brinzolamide 1%/timolol 0.5% in the treatment of elevated intraocular pressure in open-angle glaucoma and ocular hypertension

Brinzolamide/timolol versus dorzolamide/timolol fixed combinations: A hospital-based, prospective, randomized study

PURPOSE

To compare the efficacy and tolerability of brinzolamide/timolol (BT) and dorzolamide/timolol (DT) fixed combinations on intraocular pressure (IOP) reduction.

METHODS

Patients with primary open angle glaucoma or normal tension glaucoma were randomized to receive either BT or DT. IOPs were measured at baseline, 2 weeks, and 1, 2, and 3 months. The primary outcome measures were the mean change in IOP from baseline at each visit. Secondary outcome measures included the tolerability of each fixed combination.

RESULTS

Seventy-three patients (73 eyes) were included; 37 eyes in BT group and 36 eyes in DT group. Baseline mean IOP were 24.14 ± 4.5 and 29.53 ± 6 mmHg for BT and DT, respectively (P < 0.001). Both BT and DT provided statistically significant mean IOP reductions from baseline values within each group at all study visits (P < 0.001). DT provided greater mean IOP reductions from baseline than BT at each visit which was statistically significant at 2 weeks (P = 0.037). Mean percentage of IOP reduction was 24.35% and 46.33% at 2 weeks (P < 0.001), and 24.65% and 47% at 3 months (P < 0.001) for BT and DT, respectively. Patients' tolerability appeared to be better for DT than for BT with complete ocular comfort without any ocular adverse effects in 31 patients (81.1%) in DT group and 11 patients (29.7%) in BT group (P < 0.001).

CONCLUSION

Both drops provide effective IOP reduction which was greater, and patients were more likely to achieve lower target pressures with DT than with BT.

Short-term effect of topical brinzolamide 1%-timolol 0.5% fixed combination on human central corneal thickness

PURPOSE

To evaluate the short-term effect of fixed combination of brinzolamide 1% and timolol 0.5% (FCBT) application on human central corneal thickness (CCT).

METHODS

This prospective clinical study included 97 patients having Nd:YAG laser posterior capsulotomy for posterior capsule opacification. Patients were randomized to receive apraclonidine hydrochloride 0.5% (APRA) (n=48) or FCBT (n=49) at 1 h before laser surgery. The baseline CCT was evaluated by ultrasonographic pachymetry from the central region ∼1 h before the laser procedure. CCT measurements were applied just before the laser application and then the first, second, and third hour, and the first, third, and seventh day after the Nd:YAG laser capsulotomy.

RESULTS

There was no statistically significant difference between the baseline intraocular pressures, CCTs, and demographic and clinical data (age, sex, surgery laser interval, total laser energy) of the APRA and the FCBT groups. The mean CCT values of the APRA group at the first, second, and third hour, and the first, third, and seventh day were 553.8±28.0, 551.4±35.3, 556.8±28.7, 552.6±27.5, 548.2±26.2, and 546.2±25.5 μm, respectively. The mean CCT values of the FCBT group at the first, second, and third hour, and the first, third, and seventh day were 544.21±34.4, 549.4±27.6, 555.94±33.1, 550.8±33.4, 547.2±33.6, and 544.9±33.4 μm, respectively. No statistically significant difference was detected between the 2 groups.

CONCLUSION

The difference in CCT increase between both groups was not statistically significant at any follow-up visits. FCBT application does not have a short-term effect on CCT.

Efficacy and safety of brinzolamide/timolol fixed combination compared with timolol in Japanese patients with open-angle glaucoma or ocular hypertension

Purpose

To evaluate the efficacy and safety of brinzolamide 1%/timolol 0.5% fixed-combination (BRINZ/TIM-FC) therapy compared with timolol 0.5% (TIM) monotherapy in Japanese patients with open-angle glaucoma or ocular hypertension.

Methods

This randomized, double-masked, multicenter study included Japanese patients aged ≥20 years. Patients were treated during a 4-week observation period with TIM monotherapy in advance of randomization to treatment with topical BRINZ/TIM-FC or TIM monotherapy twice daily for 8 weeks. The primary endpoint was mean reduction in intraocular pressure (IOP) from baseline to week 8 at 2 hours postinstillation. Adverse events (AEs) were recorded at each visit.

Results

A total of 301 patients (BRINZ/TIM-FC, n=150; TIM, n=151; age [mean ± standard deviation], 61±13 years) were enrolled. Mean IOP reductions from baseline were greater with BRINZ/TIM-FC than with TIM at weeks 4 and 8 at 0 and 2 hours postinstillation (all P≤0.0001), with mean reductions of −3.2 mmHg with BRINZ/TIM-FC and −1.4 mmHg with TIM at week 8, 2 hours postinstillation. Although AEs were observed in 19% of all patients (BRINZ/TIM-FC, 20%; TIM, 19%), all AEs were mild or moderate.

Conclusion

BRINZ/TIM-FC therapy was associated with significantly greater reductions in IOP compared with TIM, and it was well tolerated in Japanese patients with open-angle glaucoma or ocular hypertension.

Phase III safety and efficacy study of long-term brinzolamide/timolol fixed combination in Japanese patients with open-angle glaucoma or ocular hypertension

BACKGROUND

The purpose of this study was to evaluate the safety and efficacy of a long-term, twice-daily brinzolamide 1%/timolol 0.5% fixed combination ophthalmic suspension (BRINZ/TIM-FC) in Japanese patients with open-angle glaucoma (primary open-angle, normal-tension, exfoliation, or pigmentary) or ocular hypertension.

METHODS

This was a prospective, nonrandomized, multicenter, open-label, Phase III study of Japanese patients aged ≥20 years with diagnoses of open-angle glaucoma or ocular hypertension. Patients were treated with topical BRINZ/TIM-FC twice daily for 52 weeks. The primary endpoint was mean reduction from baseline in intraocular pressure. Data were analyzed using repeated-measures analysis of variance and t-tests. Adverse events and ophthalmic, physiologic, and laboratory parameters were measured throughout the study as safety endpoints. A total of 126 patients (mean ± SD age, 63±12 years) were enrolled, and 125 received BRINZ/TIM-FC.

RESULTS

Mean intraocular pressure was significantly reduced from baseline at weeks 4 through 52, with changes ranging from -4.1 mmHg to -5.7 mmHg (P<0.0001, all time points). Adverse events related to BRINZ/TIM-FC treatment were observed in 22% of patients. No substantial changes from baseline were observed in ophthalmic, physiologic, or laboratory variables.

CONCLUSION

Long-term, twice-daily BRINZ/TIM-FC therapy produced and maintained significant intraocular pressure reductions and was generally well tolerated in Japanese patients with open-angle glaucoma or ocular hypertension.

Fixed topical combinations in glaucomatous patients and ocular discomfort

OBJECTIVE

The purpose of this study was to verify the ocular comfort of a fixed topical combination of brinzolamide 1% plus timolol 0.5% suspension vs. dorzolamide 2% plus timolol 0.5% solution, both preserved with benzalkonium chloride (BAK), in patients with primary open-angle glaucoma (POAG) through subjective and objective methods. BAK is the most commonly used preservative in topical glaucoma medications.

METHODS

62 subjects were examined and included in the analysis. Each patient was asked to complete a questionnaire on symptoms (Ocular Surface Disease Index) and then underwent a series of examinations. The Ocular Protection Index evaluated the risk of damage to the ocular surface, and was expressed as the ratio between fluorescein breakup time and blinking interval. These and other analyses were repeated 30 days after instillation of the new eye drop treatment.

RESULTS

The results demonstrated that patients enrolled with the preserved fixed combination of dorzolamide or brinzolamide represented a subgroup of patients in which the discomfort symptoms were supposedly justified by the presence of BAK used chronically in antihypertensive drops. Ocular discomfort scores were significantly higher with dorzolamide/timolol than brinzolamide/timolol (p < 0.0001).

CONCLUSIONS

This work shows the better tolerability of brinzolamide 1% plus timolol 0.5% suspension, compared with dorzolamide 2% plus timolol 0.5% solution. Fortunately, some of the adverse reactions induced by preserved eye drop glaucoma medication are reversible after removing the preservatives. Both the potential for added benefit and patient compliance should be considered when selecting ocular hypotensive therapy.

Brinzolamide-timolol suspension: acceptability and side effect profile

Background:

This study aimed to determine the frequency, nature, and impact of side effects associated with the use of brinzolamide-timolol suspension, a topical ocular antihypertensive preparation.

Methods:

A questionnaire was distributed to 76 consecutive patients attending the Sunderland Eye Infirmary Glaucoma Service who were using the brinzolamide-timolol suspension. The questions related specifically to effects on daily life, blurring of vision, stinging, irritation, and acceptability compared with any drops previously used. Respondents were asked to grade their answers to these questions using a numerical scale from 0 to 10.

Results:

Seventy-six patients (100%) responded, comprising 58 females and 18 males, aged 68–95 years, treated for 3–7 months. Quality of life was not significantly affected, with the majority of patients recording a response between 0 and 2. Visual blurring was a more prominent feature, with the most common scores being 3 and 4. Stinging did not appear to be a prominent feature, with 0 as the most common response. Similarly, irritation was not a common finding, with most respondents scoring 0 and 1. Finally, the brinzolamide-timolol suspension compared favorably with previously used drops, with the vast majority of patients expressing a preference for this suspension over other topical medications.

Conclusion:

Brinzolamide-timolol suspension appears to be a well tolerated and acceptable medication, with minimal effect on patient quality of life.