Which glaucoma therapy combination is best?

A travoprost - travoprost/timolol (T-TT) treatment sequence is more effective at preventing the need for a third-line treatment than a latanoprost - latanoprost/timolol (L-LT) treatment sequence, according to a report published in the January/February issue of the European Journal of Ophthalmology.

Philippe Denis from the Hopital Edouard Herriot, Lyon and colleagues from centres across France compared the effectiveness of the two treatment sequences in the treatment of open-angle glaucoma (OAG) by constructing a discrete event simulation (DES) model. Patients with OAG and ocular hypertension (OHT) were given a prostaglandin (latanoprost or travoprost) as first-line treatment. In cases where the treatment failed, patients were switched to a specific prostaglandin-timolol treatment sequence, either LT or TT.

Latanoprost treatment resulted in more failures than travoprost (p<0.01) and the LT sequence resulted in more failures than the TT sequence (p<0.01). At 60 months, the probability of starting a third treatment line was 39.2% with L-LT versus 29.9% with T-TT patients. The probability of no disease progression at 60 months was 61.4% with L-LT and 65.5% with T-TT.

Based on these results, the authors believe that a T-TT treatment sequence is more effective than an L-LT sequence.