Efficiency and safety of the latanoprost and dorzolamide fixed combination in primary open-angle glaucoma initial hypotensive treatment

Purpose: to study the efficacy and safety of latanoprost/dorzolamide fixed combination Dorzoprost in primary open-angle glaucoma (POAG) as initial hypotensive treatment. Material and methods. An observational study included 30 patients (33 eyes) with moderate and advanced POAG with elevated IOP without hypotensive treatment. At the screening Dorzoprost was prescribed as a single evening instillation. The endpoints were IOP, visual acuity, MD, PSD, retinal nerve fiber layer thickness, minimal width of the neuroretinal rim, macula retinal nerve fiber layer thickness, and adverse events. The observation period was 12 weeks. IOP was measured at 1, 4 and 12 weeks. Results. After 1 week, there was a statistically significant decrease in IOP, which remained stable at 12 weeks. The average IOP decrease was 33%. Positive insufficient dynamics of visual acuity, static perimetry and optical coherence tomography parameters was registered. By the end of the observation period, in 9 cases, the appearance of mild conjunctival hyperemia was noted without an increase in the severity of signs of the “dry eye” syndrome. Conclusion. Dorzoprost demonstrated a significant hypotensive effect during initial therapy, a good safety and tolerability profile.

1. European Glaucoma Society. Terminology and guidelines for glaucoma. 5th edition ed: Savona, Italy PubliComm; 2020.

2. Clinical Gidelines “Primary open angle glaucoma”. 2020 (16.02.2021), Approved by the Ministry of Health of the Russian Federation (In Russ.).

3. Nesterov A.P. Glaucoma. Moscow: Medicine; 1995 (In Russ.).

4. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006 Mar; 90 (3): 262–7. doi: 10.1136/bjo.2005.081224

5. Neroev V.V., Mikhailova L.A. Ophthalmic morbidity in Russia. In: Avetisov S.E., Egorov E.A., Moshetova L.K., Takhchidi Kh.P., eds. Ophthalmology. National Guidelines. Moscow: GEOTAR-Media, 2018: 15–9 (In Russ.).

6. Jonas JB, Aung T, Bourne RR, et al. Glaucoma. 2017 Nov 11; 390 (10108): 2183–93. doi: 10.1016/S0140-6736(17)31469-1

7. World report on vision. World Health Organization. 2019 [29.02.2024]. Available from: https://cdn.who.int/media/docs/default-source/blindness-and-visual-impairment/9789241516570-eng.pdf?sfvrsn=dd15adbb_3.

8. Tham YC, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014 Nov; 121 (11): 2081–90. doi: 10.1016/j.ophtha.2014.05.013

9. Hommer A, Hubatsch DA, Cano-Parra J. Safety and efficacy of adding fixed-combination Brinzolamide/Timolol Maleate to prostaglandin therapy for treatment of ocular hypertension or glaucoma. J Ophthalmol. 2015; 2015: 131970. doi: 10.1155/2015/131970

10. Lanzl I, Raber T. Efficacy and tolerability of the fixed combination of brinzolamide 1% and timolol 0.5 % in daily practice. Clin Ophthalmol. 2011; 5: 291–8. doi: 10.2147/OPTH.S16355

11. Webers CA, Beckers HJ, Nuijts RM, Schouten JS. Pharmacological management of primary open-angle glaucoma: second-line options and beyond. Drugs Aging. 2008; 25 (9): 729–59. doi: 10.2165/00002512-200825090-00002

12. Hollo G, Topouzis F, Fechtner RD. Fixed-combination intraocular pressure-lowering therapy for glaucoma and ocular hypertension: advantages in clinical practice. Expert Opin Pharmacother. 2014 Aug; 15 (12): 1737–47. doi: 10.1517/14656566.2014.936850

13. Djafari F, Lesk MR, Harasymowycz PJ, Desjardins D, Lachaine J. Determinants of adherence to glaucoma medical therapy in a long-term patient population. J Glaucoma. 2009 Mar; 18 (3): 238–43. doi: 10.1097/IJG.0b013e318181542

14. Patel SC, Spaeth GL. Compliance in patients prescribed eyedrops for glaucoma. Ophthalmic Surg. 1995 May-Jun; 26 (3): 233–6. PMID: 7651690.

15. Dunker S, Schmucker A, Maier H. Latanoprost/Timolol Fixed Combination Study Group. Tolerability, quality of life, and persistency of use in patients with glaucoma who are switched to the fixed combination of latanoprost and timolol. Adv Ther. 2007 Mar-Apr; 24 (2): 376–86. doi: 10.1007/BF02849907

16. Brandt JD, Cantor LB, Katz LJ, et al. Bimatoprost/timolol fixed combination: a 3-month double-masked, randomized parallel comparison to its individual components in patients with glaucoma or ocular hypertension. J Glaucoma. 2008 Apr-May; 17(3): 211–6. doi: 10.1097/IJG.0b013e3181507313. Erratum in: J Glaucoma. 2010 Aug; 19 (6): 423.

17. Konstas AG, Hollo G, Mikropoulos D, et al. Twenty-four-hour intraocular pressure control with bimatoprost and the bimatoprost/timolol fixed combination administered in the morning, or evening in exfoliative glaucoma. Br J Ophthalmol. 2010 Feb; 94 (2): 209–13. doi: 10.1136/bjo.2008.155317

18. Zhuravleva A.N., Zueva M.V., Shustov E.B. Optimization of medicinal treatment of patients with glaucoma in combination with concurrent system pathology. Part 1: Cardiovascular pathologyy. Ophthalmology in Russia. 2020; 17 (3): 321–9 (In Russ.). doi:10.18008/1816-5095-2020-3-321-329

19. Instruction for Timolol-SOLOpharm medical using (In Russ.). Available at: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=e879f1bb-52a5-4917-9e11-2cb8cde1e56e (date of the application: 19.08.2023).

20. The PRIMA study: trimetazidin in the treatment of patients with stable angina pectoris after myocardial infarction. Epidemiological and clinical phases]. Kardiologiia. 2008; 48 (12): 10–3 (In Russ.). PMID: 19076088.

21. Gandolfi SA, Lim J, Sanseau AC, Parra Restrepo JC, Hamacher T. Randomized trial of brinzolamide/brimonidine versus brinzolamide plus brimonidine for open-angle glaucoma or ocular hypertension. Adv Ther. 2014 Dec; 31 (12): 1213–27. doi: 10.1007/s12325-014-0168-y