Intraocular pressure after replacement of current dual therapy with latanoprost monotherapy in patients with open angle glaucoma

Aims: To evaluate the efficacy and safety of replacing current dual ocular hypotensive therapy with latanoprost 0.005% monotherapy in patients with open angle glaucoma. Methods: This randomised, open label, parallel group, multinational study included 466 patients with open angle glaucoma currently on dual ocular hypotensive therapy, including a beta adrenergic receptor antagonist. Patients were assigned ( 1: 3) to ongoing dual therapy or a switch to monotherapy with latanoprost 0.005% once daily for 6 months. Intraocular pressure (IOP) was measured at 10 am and 5 pm at baseline, month 3, and month 6. Groups were compared for differences in diurnal IOP change, IOP success rates (IOP less than or equal to 22 mm Hg with less than or equal to 15% increase from baseline), and clinical success rates ( not requiring change in therapy). Results: Baseline mean diurnal IOP was 17.8 (SD 2.0) mm Hg in the latanoprost group and 17.6 (2.1) mm Hg in the dual therapy group. After 6 months, mean diurnal IOP was reduced by 0.26 (0.18) (SEM 1.4%) mm Hg (p = 0.153) in the group switched to latanoprost and by 0.37 (0.25) (2.1%) mm Hg (p = 0.138) in those continuing dual therapy ( difference: 0.11 mm Hg; p = 0.641). Success rates defined by IOP criteria were 83% for latanoprost and 89% for continued dual therapy ( difference: 6%; p = 0.122). Clinical success rates were 97% for latanoprost and 99% for dual therapy ( difference: 2%; p = 0.161). Ocular adverse events were reported by 23% of patients in both treatment groups. Conclusion: Latanoprost monotherapy is a safe and effective alternative for many patients with open angle glaucoma requiring dual topical ocular hypotensive therapy for IOP control.