Efficacy and tolerability of latanoprost compared with timolol in the treatment of patients with chronic angle-closure glaucoma

Objective: To evaluate the efficacy and tolerability of latanoprost compared with timolol in the treatment of patients with chronic angle-closure glaucoma (CACG). Methods: Pertinent publications were identified through systematic searches of PubMed, EMBASE, the Cochrane Controlled Trials Register and the Chinese Biomedicine Database. Randomized controlled trials comparing latanoprost with timolol in patients with chronic angle-closure glaucoma (CACG) who had inadequate intraocular pressure (IOP) control after peripheral iridotomy (PI) were selected. The main efficacy measures were the weighted mean difference (WMD) in the reduction from baseline to end of treatment in IOP at peak, trough, and diurnal curve. The main tolerability measures were the odds ratio (OR) for the individual adverse events. The pooled estimates and 95% confidence intervals (CIs) were carried out in RevMan version 5.2 software. Results: Five published randomized controlled trials involving 528 patients were included in the present meta-analysis. The IOP reduction (IOPR) was significantly greater in the latanoprost group than in the timolol group at diurnal curve (WMD: 2.22 mmHg [95% CI, 1.65 to 2.79], P<0.00001), peak (WMD: 2.44 mmHg [0.85 to 4.03], P=0.003) and trough (WMD: 2.67 mmHg [1.93 to 3.41], P<0.00001). Timolol caused conjunctival hyperemia in less patients than latanoprost (pooled OR: 2.74 [95% CI, 1.33 to 5.61], P=0.006). Conclusions: Latanoprost provides greater IOP-lowering efficacy than timolol in the treatment of patients with CACG. Latanoprost caused conjunctival hyperemia in more patients than timolol. Further clinical trials are needed because of short duration of included studies.