Combining benefits in glaucoma

Attacking glaucoma with a combination treatment strategy achieves a significant reduction in intraocular pressure in patients unresponsive to monotherapy, according to a study presented at the annual meeting of ARVO in Florida.

Preliminary results of the EXACCT study [Evaluation of Xalatan (latanoprost) and Cosopt (dorzolamide hydrochloride/timolol maleate)] demonstrated IOP control in 92.6% of those patients who were unresponsive to, or were uncontrolled, with latanoprost, when treated with the combination treatment, Cosopt alone, or when the investigational agent was added to latanoprost therapy.

The multicentre, open-label, 12-week EXACCT study enrolled 343 patients across Canada. The preliminary study results related to 243 participants; 196 of the patients had either open-angle glaucoma or ocular hypertension and received Cosopt in addition to latanoprost after a four-week course of latanoprost monotherapy failed to control IOP. The remaining 47 patents were completely unresponsive to latanoprost and hence were switched to Cosopt therapy.

Mark Lesk, MD, EXACCT study co-author and vision health researcher with the Guy-Bernier Research Centre at Montreal's Maisonneuve-Rosemont Hospital, University of Montreal, Canada, noted a 28.3% (15.78 mmHg vs. 22.34 mmHg) reduction of IOP from latanoprost baseline, when patients received both latanoprost and Cosopt. In latanoprost unresponsive patients, Cosopt alone achieved an average reduction of 24.4% in IOP (17.29 mmHg vs. 23.14 mmHg). According to Lesk, the overall treatment strategy was generally well tolerated with the majority (77%) of adverse events being mild in nature.