Combination therapies go head to head

Azarga (brinzolamide 1%/timolol 0.5% eye drops suspension; Alcon) and Cosopt (dorzolamide 2%/timolol 0.5% eye drops solution; Merck) are equally efficacious in IOP-lowering capacity, however, Azarga offers greater ocular comfort, according to a study presented at this week's European Glaucoma Society congress in Berlin, Germany.

A team led by Dr Gianluca Manni of the University of Roma Tor Vergata, Rome, Italy, performed a one-year, multicentre, randomized, double-masked, active controlled, parallel group comparison of the two combination therapies, Azarga and Cosopt in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT) who required additional therapy. Four hundred and thirty seven patients were enrolled in centres in Italy, France, Belgium, Singapore, Lithuania, Sweden or the UK.

The treatment phase and IOP assessments included visits at week two, months three, six, nine and 12. Of the 437 patients enrolled, 220 received Azarga and 217 Cosopt.

The investigators found the treatments to have comparable IOP-lowering efficacy, with IOP reductions from baseline ranging from 7.2 to 9.2 mmHg in the Azarga group (mean IOP range 16.7 to 18.8 mmHg) and from 7.4 to 8.9 mmHg for Cosopt (mean IOP range 16.9 to 19.4 mmHg). Up to 60% and 59% of patients had IOP

Although the investigators reported a similar safety profile amongst both groups, Azarga did show a local comfort advantage over Cosopt in terms of ocular irritation (2.7% vs 10.6%) and ocular pain (2.7% vs 6.5%).

The researchers concluded that, although the two combination therapies were equally efficacious in their ability to lower IOP in OAG or OHT patients, Azarga showed greater local ocular comfort when compared with Cosopt.