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首页> 外文期刊>British journal of ophthalmology >Meta-analysis of randomised controlled trials comparing latanoprost with timolol in the treatment of patients with open angle glaucoma or ocular hypertension.
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Meta-analysis of randomised controlled trials comparing latanoprost with timolol in the treatment of patients with open angle glaucoma or ocular hypertension.

机译：对拉坦前列素与噻吗洛尔治疗开角型青光眼或高眼压症患者进行随机对照试验的荟萃分析。

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AIM: To evaluate the comparative efficacy and tolerance of latanoprost versus timolol through a meta-analysis of randomised controlled trials (RCTs). METHODS: Systematic retrieval of RCTs of latanoprost versus timolol to allow pooling of results from head to head comparison studies. Quality of trials was assessed based on randomisation, masking, and withdrawal. Sensitivity analyses were used to estimate the effects of quality of study on outcomes. The data sources were Medline, Embase, Scientific Citation Index, Merck Glaucoma, and Pharmacia and Upjohn ophthalmology databases. There were 1256 patients with open angle glaucoma or ocular hypertension reported in 11 trials of latanoprost versus timolol. The main outcome measures were (i) percentage intraocular pressure (IOP) reduction for efficacy; (ii) relative risk, risk difference, and number needed to harm for side effects such as hyperaemia, conjunctivitis, increased pigmentation, hypotension, and bradycardia expressed as dichotomous outcomes; and (iii) reduction in systemic blood pressure and heart rate as side effects. RESULTS: Both 0.005% latanoprost once daily and 0.5% timolol twice daily reduced IOP. The percentage reductions in IOP from baseline (mean (SE)) produced by latanoprost and timolol were 30.2 (2.3) and 26.9 (3.4) at 3 months. The difference in IOP reduction between the two treatments were 5.0 (95% confidence intervals 2.8, 7.3). However, latanoprost caused iris pigmentation in more patients than timolol (relative risk = 8.01, 95% confidence intervals 1.87, 34.30). The 2 year risk with latanoprost reached 18% (51/277). Hyperaemia was also more often observed with latanoprost (relative risk =2.20, 95% confidence intervals 1.33, 3.64). Timolol caused a significant reduction in heart rate of 4 beats/minute (95% confidence interval 2, 6). CONCLUSION: This meta-analysis suggests that latanoprost is more effective than timolol in lowering IOP. However, it often causes iris pigmentation. While current evidence suggests that this pigmentation is benign, careful lifetime evaluation of patients is still justified.
机译：目的：通过对随机对照试验（RCT）进行荟萃分析，评估拉坦前列素与噻吗洛尔的相对疗效和耐受性。方法：系统检索拉坦前列素与噻吗洛尔的RCT，以汇总头对头比较研究的结果。根据随机，掩盖和退出评估试验质量。敏感性分析用于估计研究质量对结果的影响。数据来源为Medline，Embase，科学引文索引，Merck Glaucoma以及Pharmacia和Upjohn眼科数据库。拉坦前列素与噻吗洛尔的11项试验报告了1256例开角型青光眼或高眼压症患者。主要结果指标是：（i）降低眼内压百分比（IOP）以提高疗效; （ii）相对风险，风险差异和损害所需的数量，这些副作用包括充血，结膜炎，色素沉着增加，低血压和心动过缓，以二分结果表示; （iii）降低全身性血压和心率作为副作用。结果：每天一次0.005％拉坦前列素和每天两次0.5％噻吗洛尔均降低IOP。拉坦前列素和噻吗洛尔在3个月时产生的IOP相对于基线（平均（SE））的降低百分比分别为30.2（2.3）和26.9（3.4）。两种治疗之间的IOP降低差异为5.0（95％置信区间2.8、7.3）。但是，拉坦前列素引起的患者虹膜色素沉着多于噻吗洛尔（相对危险度= 8.01，95％置信区间1.87，34.30）。拉坦前列素的2年风险达到18％（51/277）。拉坦前列素也常发生充血（相对危险度= 2.20，95％置信区间1.33、3.64）。替莫洛尔引起心率显着降低，为4次/分钟（95％置信区间2、6）。结论：这项荟萃分析表明，拉坦前列素在降低眼压方面比替莫洛尔更有效。但是，它通常会引起虹膜色素沉着。尽管目前的证据表明这种色素沉着是良性的，但仍需对患者进行仔细的终生评估。

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