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Brinzolamide plus brimonidine for the treatment of glaucoma: an update

INTRODUCTION: Glaucoma is a common sight-threatening condition that is primarily treated by lowering intraocular pressure (IOP). Today the mainstay of treatment is topical ocular hypotensive medications; many patients require more than one agent to achieve target IOP. For such patients, fixed combination formulations have several advantages including simplicity of treatment regimen, adherence to the treatment regimen, efficacy, improved ocular surface comfort and reduced cost. All currently available fixed combinations contain a β-blocker, which is contraindicated in some patients. Hence there is a clinical need for fixed-combination preparations without a β-blocker. This paper reviews the current literature on a new fixed-combination drug containing brinzolamide 1% and brimonidine 0.2% (BBFC).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Glaucoma: Diagnosis and Management of Chronic Open Angle Glaucoma and Ocular Hypertension

This guideline covers adults (18 and older) with a diagnosis of chronic open angle glaucoma or ocular hypertension and those with chronic open angle glaucoma or ocular hypertension associated with pseudoexfoliation or pigment dispersion. In addition, the guideline will cover populations who have a higher prevalence of glaucoma and may have worse clinical outcomes including people with a family history of glaucoma, younger people (<50 years) and people who are of black African or black Caribbean descent. Options for pharmacological, surgical, laser and complimentary or alternative treatments are considered in terms of clinical effectiveness and cost effectiveness.

NICE Clinical Guidelines - National Collaborating Centre for Acute Care (UK).

Version: April 2009
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Meta-analysis of alpha2-adrenergic agonists versus carbonic anhydrase inhibitors as adjunctive therapy

The review concluded that brimonidine provided greater intraocular lowering efficacy than topical anhydrase inhibitors as adjunctive therapy to beta blockers or prostaglandin analogues in patients with glaucoma or ocular hypertension. The review was unable to rule out the possibility of publication bias and there was substantial heterogeneity in the overall analyses so the authors' conclusions should be considered tentative.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Intraocular pressure-lowering effects of commonly used fixed-combination drugs with timolol: a systematic review and meta-analysis

The review concluded that all six commonly used drug combinations containing timolol could effectively lower intra-ocular pressure in patients with primary open-angle glaucoma and ocular hypertension. The authors' conclusions were based on the evidence but the relatively small sample sizes for some drug combinations, uncertain heterogeneity and uncertainty regarding the appropriateness of the synthesis should be considered.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Intraocular pressure-lowering effects of all commonly used glaucoma drugs: a meta-analysis of randomized clinical trials

The reviewed aimed to determine the effectiveness of the most frequently prescribed intraocular pressure-reducing agents in patients with glaucoma. The authors' conclusion, that there are multiple options for effective monotherapy in this population, should be viewed with some caution because of incomplete reporting of the review process and limitations in the analysis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Meta-analysis of medical intervention for normal tension glaucoma

The authors concluded that latanoprost, bimatoprost and timolol were the most effective intraocular pressure lowering agents in patients with normal tension glaucoma. However, the method of combining studies in this review appeared to be inappropriate and therefore the conclusions must be treated with some caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Systematic review of intraocular pressure-lowering effects of adjunctive medications added to latanoprost

This review found that adjunctive medications added to latanoprost (0.005%) decreased intra-ocular pressure in patients with primary open-angle glaucoma or ocular hypertension, especially with timolol (0.5% once daily). The limitations of the data and review methods, particularly the flaws in the analysis, mean that the findings of the review are unlikely to be reliable and should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

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