Br J Ophthalmol 2000;84:181-185
( February )
Comparison of the intraocular pressure lowering effect of
latanoprost and a fixed combination of timolol-pilocarpine eye drops in
patients insufficiently controlled with 
adrenergic antagonists
Jean-Philippe Nordmanna, Mats Söderströmb, Jean-François Roulandc d, François Malecaze, the French Latanoprost Study Group, and the Swedish Latanoprost Study Group
a Department of
Ophthalmology, Hôpital des Quinze-Vingts, Paris, France, b Department of Ophthalmology, Huddinge
University Hospital, Sweden, c Department of Ophthalmology, Hôpital Huriez,
Lille, France, d Department
of Ophthalmology, Hôpital Purpan, Toulouse, France
Correspondence to: Jean-Philippe Nordmann, MD,
PhD, Department of Ophthalmology, Hôpital des Quinze-Vingts, 28 rue
de Charenton, 75012 Paris,
France
Accepted for publication 15 September 1999
AIMS
To compare the
effect on intraocular pressure (IOP) of latanoprost monotherapy and
timolol-pilocarpine in patients with glaucoma or ocular hypertension
with inadequately controlled IOP on topical 
adrenergic antagonists.
METHODSThis was a
multicentre, randomised, observer masked, 6 week study performed in
France and Sweden. 23 centres enrolled 237 patients with glaucoma or
ocular hypertension and an IOP of at least 22 mm Hg on treatment with
topical adrenergic antagonists, alone or in combination. After a 21 day run in period on timolol 0.5% twice daily, patients were
randomised either to latanoprost 0.005% once daily or to a fixed
combination of timolol-pilocarpine twice daily. Changes in mean diurnal
IOP from the baseline to the 6 week visit were determined with an
analysis of covariance.
RESULTSMean diurnal
IOP was statistically significantly decreased from baseline in both
groups (p<0.001). Switching to latanoprost treatment reduced mean
diurnal IOP by 5.4 (SEM 0.3) mm Hg (ANCOVA 
22%) and switching to
timolol-pilocarpine treatment reduced mean diurnal IOP by 4.9 (0.4) mm
Hg (20%). Blurred vision, decreased visual acuity, decreased
twilight vision, and headache were statistically significantly more
frequent in the timolol-pilocarpine group.
CONCLUSIONSLatanoprost
monotherapy was at least as effective as fixed combination
timolol-pilocarpine twice daily treatment in reducing mean diurnal IOP
in patients not adequately controlled on topical adrenergic
antagonists. Latanoprost was better tolerated than timolol-pilocarpine
regarding side effects. These results indicate that a switch to
latanoprost monotherapy can be attempted before combination therapy is initiated.
© 2000 by British Journal of Ophthalmology
