A 1-year study of brimonidine twice daily in glaucoma and ocular hypertension. A controlled, randomized, multicenter clinical trial. Chronic Brimonidine Study Group
J. S. Schuman, B. Horwitz, N. T. Choplin, R. David, D. Albracht and K. Chen
New England Eye Center, Tufts University School of Medicine, Boston, Mass., USA. jss@mediaone.net
OBJECTIVE: Brimonidin tartrate is a highly selective alpha 2-agonist. This
study investigates the safety and efficacy of 0.2% brimonidine administered
twice daily for 1 year in patients with glaucoma or ocular hypertension.
METHODS: The study design was a multicenter, double-masked, randomized,
parallel-group, active-controlled comparison clinical trial. Subjects
instilled 0.2% brimonidine or 0.5% timolol maleate twice daily for 12
months. Subjects were examined at baseline, week 1, and months 1, 2, 3, 6,
9, and 12. A subset of subjects was examined at week 2. RESULTS: Of 443
subjects enrolled in this study, 374 met the entry criteria; 186 received
brimonidine and 188 received timolol. Brimonidine-treated subjects showed
an overall mean peak reduction in intraocular pressure (IOP) of 6.5 mm Hg;
timolol-treated subjects had a mean peak reduction in IOP of 6.1 mm Hg.
Brimonidine lowered mean peak IOP significantly more than timolol at week 2
and month 3 (P < .03); no significant difference was observed between
the groups for this variable at other visits throughout the 1-year course
of the study. No evidence of tachyphylaxis was seen in either group.
Allergy was seen in 9% of subjects treated with brimonidine. Dry mouth was
more common in the brimonidine-treated group than in the timolol-treated
group (33.0% vs 19.4%), but complaints of burning and stinging were more
common in the timolol-treated group (41.9%) than in the brimonidine-treated
patients (28.1%). Headache, fatigue, and drowsiness were similar in the 2
groups. In general, the tolerance to medication was acceptable.
CONCLUSIONS: Brimonidine is safe and effective in lowering IOP in
glaucomatous eyes. Brimonidine provides a sustained long-term ocular
hypotensive effect, is well tolerated, and has a low rate of allergic
response.
Effects of Topical Clonidine versus Brimonidine on Choroidal Blood Flow and Intraocular Pressure during Squatting
Weigert et al.
IOVS 2007;48:4220-4225.
ABSTRACT
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Reduced Ocular Allergy With Fixed-Combination 0.2% Brimonidine-0.5% Timolol--Reply
Sherwood et al.
Arch Ophthalmol 2007;125:717-718.
FULL TEXT
Twice-Daily 0.2% Brimonidine-0.5% Timolol Fixed-Combination Therapy vs Monotherapy With Timolol or Brimonidine in Patients With Glaucoma or Ocular Hypertension: A 12-Month Randomized Trial.
Sherwood et al.
Arch Ophthalmol 2006;124:1230-1238.
ABSTRACT
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A comparison of the fixed combination of latanoprost and timolol with the unfixed combination of brimonidine and timolol in patients with elevated intraocular pressure. A six month, evaluator masked, multicentre study in Europe
Garcia-Sanchez et al.
Br. J. Ophthalmol. 2004;88:877-883.
ABSTRACT
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Aqueous Humor Flow in Normal Human Eyes Treated With Brimonidine and Dorzolamide, Alone and in Combination
Tsukamoto and Larsson
Arch Ophthalmol 2004;122:190-193.
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Systemic Side Effects of Ophthalmic Drops
Levy and Zadok
CLIN PEDIATR 2004;43:99-101.
ABSTRACT
Should {beta} blockers be abandoned as initial monotherapy in chronic open angle glaucoma? The controversy
Goldberg et al.
Br. J. Ophthalmol. 2002;86:691-695.
FULL TEXT
Neuroprotection of Retinal Ganglion Cells by Brimonidine in Rats with Laser-Induced Chronic Ocular Hypertension
WoldeMussie et al.
IOVS 2001;42:2849-2855.
ABSTRACT
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Aqueous Humor Flow in Normal Human Eyes Treated With Brimonidine and Timolol, Alone and in Combination
Larsson
Arch Ophthalmol 2001;119:492-495.
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Comparison of the Early Effects of Brimonidine and Apraclonidine as Topical Ocular Hypotensive Agents
Maus et al.
Arch Ophthalmol 1999;117:586-591.
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Pressure or Progression?
Burnstein et al.
Arch Ophthalmol 1999;117:417-419.
FULL TEXT
Comparison of the Efficacy of Apraclonidine and Brimonidine as Aqueous Suppressants in Humans
Schadlu et al.
Arch Ophthalmol 1998;116:1441-1444.
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