Comparative effectiveness of bimatoprost 0.03% preservative free for the treatment of open-angle glaucoma and ocular hypertension

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To evaluate the comparative effectiveness of bimatoprost 0.03% preservative-free solution (BimPF) in single dose vials for the treatment of glaucoma/ocular hypertension compared to other preservative-free (PF) and non-BAK preserved prostaglandin analog and prostamide (PGA) therapies. Primary outcome of interest was change from baseline in intraocular pressure.


A systematic literature review was conducted to identify relevant randomized controlled trials investigating the IOP lowering efficacy of glaucoma treatments. The initial literature search was done in December 2011, and subsequently updated in April 2013. Trials involving preserved formulations were included to indirectly connect the efficacy evidence of PF and non-BAK preserved PGA therapies. A Bayesian mixed treatment comparison was used to synthesize the network of evidence. Timolol was used as the reference comparator, as it was the most common comparator in the glaucoma medication trials.


The initial literature search resulted in 151 trials to be included in the network. The updated literature search resulted in the addition of 4 additional trials. In total, 84 comparator arms were included in the network. Relative to timolol, BimPF showed a significant difference in IOP lowering efficacy relative to timolol, while all other PF and non-BAK preserved PGA therapies did not. Additionally, BimPF showed the greatest mean change from baseline in IOP compared to all the PF and non-BAK preserved PGA therapies, although the differences were non-significant.


BimPF is the only PF or non-BAK preserved PGA therapy to show a significantly greater IOP lowering efficacy than timolol.

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