Considerations in glaucoma therapy: fixed combinations versus their component medications

Figures & data

Table 1 Comparison studies of the efficacy and safety of fixed combinations relative to their active components

Study (n)	Study arms	Study duration	Timing of IOP measurements	Efficacy in IOP lowering	Tolerability
FCDT vs each component^Citation7 (335)	FCDT bid Dorzolamide tid Timolol bid	3 months	8:30 AM (trough) and 10:30 AM (peak) at baseline, day 1, week 2, and months 1, 2, and 3	FCDT more effective than timolol or dorzolamide at all measurements	No significant difference among treatment groups in the overall incidence of adverse events
FCDT vs each component^Citation8 (253)	FCDT bid Dorzolamide tid Timolol bid	3 months	9 AM (trough) and 11 AM (peak) at baseline, week 2, and months 1, 2, and 3	FCDT more effective than timolol or dorzolamide at 7 of 8 measurements	Similar incidence of adverse events with FCDT vs dorzolamide; fewer adverse events with timolol vs FCDT
FCLT vs each component^Citation9 (418)	FCLT qd (AM) Latanoprost qd (PM) Timolol bid	6 months (masked phase)	8 AM, 10 AM, and 4 PM at baseline and weeks 2, 13, and 26; 8 AM at week 6	FCLT more effective than timolol or latanoprost across 6 months of treatment	Bulbar conjunctival hyperemia reported for twice as many latanoprost patients as FCLT patients; lower incidence with timolol
FCLT vs each component^Citation10 (436)	FCLT qd (AM) Latanoprost qd (AM) Timolol bid	6 months (masked phase)	8 AM, 10 AM, and 4 PM at baseline and weeks 2, 13, and 26; 8 AM at week 6	FCLT more effective than timolol or latanoprost across 6 months of treatment	Conjunctival hyperemia reported for twice as many FCLT patients as latanoprost patients; lower incidence with timolol
FCBT vs each component^Citation11 (1159)	FCBT bid Brimonidine tid Timolol bid	1 year	8 AM, 10 AM, 3 PM, and 5 PM at baseline, weeks 2 and 6, and months 3, 6, and 12; 8 AM and 10 AM at month 9	FCBT more effective than timolol at all measurements and more effective than brimonidine at all 8 AM, 10 AM, and 3 PM measurements	Lower incidence of adverse events (ocular allergy/inflammation, oral dryness) and fewer discontinuations due to adverse events with FCBT vs brimonidine; fewer adverse events with timolol vs FCBT
FCBimT vs each component^Citation12 (1061)	FCBimT qd (AM) Bimatoprost qd (PM) Timolol bid	3 months	8 AM, 10 AM, and 4 PM at baseline, weeks 2 and 6, and month 3	FCBimT more effective than timolol at all measurements and bimatoprost at 5 of 9 measurements	Lower incidence of adverse events (conjunctival hyperemia) and fewer discontinuations due to adverse events with FCBimT vs bimatoprost; fewer adverse events with timolol vs FCBimT
FCTT vs each component^Citation13 (263)	FCTT qd (AM) Travoprost (qd) Timolol (bid)	3 months	8 AM, 10 AM, and 4 PM at baseline, weeks 2 and 6, and month 3	FCTT more effective than timolol at all measurements and travoprost at 7 of 9 measurements	Similar incidence of conjunctival hyperemia with FCTT vs travoprost; lower incidence of conjunctival hyperemia with timolol vs FCTT

Abbreviations: FCDT, fixed-combination dorzolamide/timolol (Cosopt); FCLT, fixed-combination latanoprost/timolol (Xalacom); FCBT, fixed-combination brimonidine/timolol (Combigan); FCBimT, fixed-combination bimatoprost/timolol (Ganfort); FCTT, fixed-combination travoprost/timolol (DuoTrav); bid, twice daily; tid, 3 times daily; qd, daily.

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