Comparative effectiveness of bimatoprost 0.03% / timolol 0.5% preservative free fixed combination (BTFC PF) for the treatment of open-angle glaucoma and ocular hypertension

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Abstract

Purpose

To evaluate the comparative effectiveness of BTFC PF solution in single dose vials for the treatment of glaucoma/ocular hypertension compared to other preservative-free (PF) fixed combination and PF monotherapies. Primary outcome of interest was change from baseline in intraocular pressure.

Methods

A systematic literature review was conducted to identify relevant randomized controlled trials investigating the IOP lowering efficacy of glaucoma treatments. The literature search was performed in December 2012. Trials involving preserved formulations were included to indirectly connect the efficacy evidence of PF treatments. A Bayesian mixed treatment comparison was used to synthesize the network of evidence.

Results

The initial literature search resulted in 148 papers meeting the inclusion criteria. Of these 135 could be connected to form the evidence network, which consisted of 23 comparator arms, 6 of which were PF fixed combinations or PF monotherapies. BTFC PF showed an improvement in IOP lowering efficacy relative to all other PF therapies and the greatest mean change from baseline in IOP, although this difference was non-significant for 3 out of 5 comparisons, likely due to limited evidence for comparator PF therapies. The analysis showed a 93% probability that BTFC PF was the best of the PF treatments based on the full network analysis. All other PF therapies have a <3% chance of being best.

Conclusion

The MTC analysis showed numerical superiority of BTFC PF over all other PF treatments within the network of evidence for combination therapies.

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