Morning Vs Evening Latanoprost/Timolol Combination 

<h2 id="introduction">Introduction</h2><ul><li>Latanoprost (0.005%)/timolol maleate (0.5%) is a fixed-combination product.</li><li>Previous studies have found that the latanoprost/timolol fixed combination (LTFC) has a better IOP lowering effect than either of its respective constituents as monotherapy.</li><li>The purpose of this randomized, double-blind study was to compare the efficacy of morning versus evening dosing of LTFC in controlling IOP and IOP fluctuation in untreated patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT).</li></ul><h2 id="methods">Methods</h2><p>Double-blind, randomized clinical trial study was conducted in five centers in northern China (Beijing, Xingtai, Shijiazhuang, Handan, and Fushun) between November 2020 and November 2021</p><h2 id="participants">Participants</h2><p>Adult patients aged =18 years newly diagnosed with POAG or OHT were treated for 4 weeks. (Figure 1)</p><figure class="image"><img style="aspect-ratio:1066/514;" src="https://cdn.megawecare.com/GHBY/Internal-Images/participant-img.webp" width="1066" height="514"></figure><p><strong>Assessment parameters:</strong> Mean reduction of the 24-hour intraocular pressure (IOP) and IOP fluctuation from baseline after a 4-week treatment.</p><h2 id="result">Result</h2><ul><li>56 patients were included in the final analysis.</li><li>Post-treatment IOP values in both groups showed a significant decrease compared to the baseline values at every 24-hour measurement time point.</li><li>Significant difference between the groups in IOP reduction from baseline was observed at the 9:30 AM time point (4.01 + 2.62 vs. 2.42 + 3.23 mm Hg) evening dosing versus morning dosing group (Table 1).</li></ul><p><strong>Table 1:</strong> Comparison of Mean IOP Reduction for Individual Time Points</p><figure class="image"><img style="aspect-ratio:1057/475;" src="https://cdn.megawecare.com/GHBY/Internal-Images/dosing-group-table-1.webp" width="1057" height="475"></figure><ul><li>Both groups showed decreased IOP fluctuation after treatment. However, morning dosing group had<br>a significantly greater decrease in diurnal IOP fluctuation than that of evening dosing group (2.62 +<br>3.84 mm Hg vs. 0.93 + 3.04 mm Hg) respectively (Table 2).</li></ul><p><strong>Table 2:</strong> Comparison of 24-Hour IOP Characteristics Reduction after Treatment</p><figure class="image"><img style="aspect-ratio:1038/180;" src="https://cdn.megawecare.com/GHBY/Internal-Images/comparision-of-24hr-iop.webp" width="1038" height="180"></figure><p>Mean amplitude of intraocular pressure excursion (MAPE)</p><ul><li>24-hour IOP rhythm in the habitual body positions,at sitting during the day and supine at night at 11:30 PM, 1:30 AM, 3:30 AM, and 5:30 AM shown in figure 1.</li></ul><p><strong>Figure 1.</strong> 24-hour patterns of mean IOP in the habitual body position at each time point.</p><figure class="image"><img style="aspect-ratio:1095/369;" src="https://cdn.megawecare.com/GHBY/Internal-Images/24hr-patterns-of-mean-iop.webp" width="1095" height="369"></figure><h2>Conclusion</h2><ul><li>This double-blind, randomized clinical trial showed that LTFC with both morning and<br>evening dosing had a reasonable effect on lowering 24-hour IOP and IOP fluctuations.</li><li>Evening dosing possessed a greater IOP-lowering effect than morning dosing only at<br>9:30 AM.</li><li>However, morning dosing offers superior control of IOP fluctuation, particularly in the<br>diurnal period.</li><li>Considering the stable 24-hour IOP curve, morning dosing may be a better option for<br>LTFC than evening dosing.</li></ul>

Opthal Update 2024 Issue  3

<ul><li><a href="#introduction">Introduction</a></li><li><a href="#methods">Methods</a></li><li><a href="#participants">Participants</a></li><li><a href="#result">Result</a></li><li><a href="#conclusion">Conclusion</a></li></ul>

Morning Vs Evening Latanoprost/Timolol Combination

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