Comparison of Latanoprostene Bunod 0.024% and Timolol Maleate 0.5% in Open-Angle Glaucoma or Ocular Hypertension: The LUNAR Study

Am J Ophthalmol. 2016 Aug:168:250-259. doi: 10.1016/j.ajo.2016.05.012. Epub 2016 May 20.

Abstract

Purpose: To compare the intraocular pressure (IOP)-lowering effect of latanoprostene bunod (LBN) 0.024% with timolol maleate 0.5% in subjects with open-angle glaucoma (OAG) or ocular hypertension (OHT).

Design: Prospective, randomized, double-masked, parallel-group, noninferiority clinical trial.

Methods: Adults with OAG or OHT from 46 clinical sites (United States and European Union) were randomized 2:1 to LBN instilled once daily (QD) in the evening and vehicle in the morning or timolol instilled twice a day (BID) for 3 months. IOP was measured at week 2, week 6, and month 3 (8 AM, 12 PM, and 4 PM each visit).

Results: A total of 387 subjects (LBN, n = 259; timolol, n = 128) completed the study. Analysis of covariance showed that mean IOP reduction with LBN was not only noninferior to timolol but significantly greater (P ≤ .025) than timolol at all but the first time point in this study (week 2, 8 AM). Of LBN- and timolol-treated subjects, respectively, 31.0% and 18.5% (P = .007) had their IOP reduced ≥25% from baseline, and 17.7% and 11.1% (P = .084) had their IOP reduced to ≤18 mm Hg over all time points/visits in this study. Ocular treatment-emergent adverse events, while uncommon, appeared more frequently in the LBN group (all mild-moderate except 1 case of severe hyperemia).

Conclusions: LBN 0.024% QD in the evening was noninferior to timolol 0.5% BID over 3 months of treatment, with significantly greater IOP lowering in subjects with OAG or OHT at all but the earliest time point evaluated, and demonstrated a good safety profile.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Antihypertensive Agents / therapeutic use*
  • Double-Blind Method
  • Female
  • Glaucoma, Open-Angle / drug therapy*
  • Glaucoma, Open-Angle / physiopathology
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Ocular Hypertension / drug therapy*
  • Ocular Hypertension / physiopathology
  • Ophthalmic Solutions / therapeutic use
  • Prospective Studies
  • Prostaglandins F, Synthetic / therapeutic use*
  • Timolol
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Antihypertensive Agents
  • BOL 303259-X
  • Ophthalmic Solutions
  • Prostaglandins F, Synthetic
  • Timolol