Bimatoprost 300micrograms/ml / Timolol 5mg/ml eye drops preservative free

Netarsudil has been approved for lowering elevated intraocular pressure (IOP), showing effectiveness through two distinct mechanisms. It is also effective when used in combination with other therapies to enhance outcomes. This study aims to compare the drug's effectiveness with other treatments, both as a standalone and in combination therapies, while also assessing potential adverse effects to evaluate its overall safety and suitability. We systematically searched PubMed, Cochrane, Web of Science, and Scopus till the 7th of October. Data from eligible studies were extracted and combined using a frequentist network meta-analysis, presented as mean differences (MDs) for continuous outcomes and risk ratios (RRs) along with their 95% confidence intervals (CIs). We used the Cochrane risk-of-bias (ROB) tool to assess the quality of the included RCTs. Netarsudil 0.02%/latanoprost 0.005% fixed-dose combination (FDC) q.d. was the most effective in reducing IOP in one-, two-, and six-week follow-ups in addition to the three-month follow-up. The netarsudil-containing medication was associated with higher adverse events compared to other arms. Netarsudil 0.02%/latanoprost 0.005% FDC q.d. and bimatoprost 0.03%/timolol 0.5% FDC emerged as the most effective therapies for lowering IOP, with each showing significant advantages at different follow-up points. Both FDCs achieved substantial reductions in IOP and a high proportion of patients reaching target IOPs. However, safety profiles indicate that traditional therapies like latanoprost 0.005% and timolol 0.5% may have fewer side effects, including lower incidences of blurred vision, conjunctival hemorrhage, and conjunctival hyperemia.

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The objective of this focused narrative review is to summarize clinical and preclinical evidence on intracameral bimatoprost implants for adults with open-angle glaucoma (OAG) or ocular hypertension (OHT), focusing on comparative efficacy, safety, and adherence-related outcomes. PubMed/MEDLINE and Google Scholar were searched from inception through January 31, 2026, using combinations of the terms bimatoprost implant, bimatoprost sustained-release, bimatoprost SR, Durysta, glaucoma, and ocular hypertension. Eligible reports included human clinical trials or observational studies evaluating any intracameral bimatoprost implant dose in OAG or OHT, and relevant nonclinical pharmacokinetic or pharmacodynamic studies. Conference abstracts without full text and non-English reports were excluded. Records were screened at the title/abstract level followed by full-text review, and data were extracted on intraocular pressure change, need for rescue therapy or additional procedures, treatment-emergent adverse events (TEAEs), and corneal endothelial cell density (CECD). Across phase I/II and phase III trials, bimatoprost implants produced intraocular pressure reductions comparable to topical timolol or topical bimatoprost through early follow-up, and many eyes remained drop-free for months to a year. Corneal adverse events and CECD loss were infrequent after single administration but increased with fixed-interval repeat dosing, with a less favorable profile at higher dose strengths. It was concluded that intracameral bimatoprost implants offer a drop-sparing alternative that may reduce adherence burden, but careful patient selection and monitoring for corneal endothelial effects are central to safe use.

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Purpose: This review aims to consolidate and evaluate the clinical evidence on the efficacy and safety of benzalkonium chloride (BAK)-preserved and BAK-free latanoprost in the treatment of primary open-angle glaucoma (POAG) and ocular hypertension (OHT). The primary research question addresses whether BAK-free formulations offer comparable efficacy with improved safety profiles compared to BAK-preserved formulations. Methods: An extensive literature search was conducted using PubMed up to February 2025. Keywords included "latanoprost", "primary open-angle glaucoma", "ocular hypertension", "efficacy", and "safety". Inclusion criteria were peer-reviewed clinical trials and meta-analyses comparing latanoprost with placebo or other treatments (eg. bimatoprost, travoprost, tafluprost, latanoprostene bunod). Exclusion criteria included observational studies, review articles, and studies comparing preservative-free prostaglandin analogues and omidenepag. Results: Thirty-two studies (17 randomized clinical trials and 7 meta-analyses) were reviewed. Latanoprost, the first FDA-approved prostaglandin analogue, primarily increases uveoscleral outflow. Comparative studies indicate that latanoprost achieves a good balance between IOP reduction and tolerability compared to bimatoprost, travoprost, tafluprost, and unoprostone. Latanoprost also reduces visual field progression and maintains central corneal thickness (CCT). It improves ocular perfusion pressure (OPP), reducing the risk of glaucomatous optic neuropathy. Safety profiles show fewer side effects, such as conjunctival hyperemia, hypertrichosis, and periocular pigmentation, compared to other PGAs. BAK-free formulations demonstrate improved corneal health and patient compliance due to reduced ocular surface toxicity. Conclusion: Latanoprost remains a first-line therapy for POAG and OHT due to its efficacy, safety, and patient adherence. The availability of BAK-free formulations enhances its therapeutic profile, with reduced corneal toxicity making it a preferred choice for long-term glaucoma management.

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) ophthalmic solution in the treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT). METHODS: MERCURY-3 was a 6-month prospective, double-masked, randomized, multicenter, active-controlled, parallel-group, non-inferiority study. Patients (≥ 18 years) with a diagnosis of OAG or OHT in both eyes that was insufficiently controlled with topical medication (IOP ≥ 17 mmHg in ≥ 1 eye and < 28 mmHg in both eyes) were included. Following washout, patients were randomized to once-daily NET/LAT or BIM/TIM for up to 6 months; efficacy was assessed at Week 2, Week 4, and Month 3; safety was evaluated for 6 months. Comparison of NET/LAT relative to BIM/TIM for mean IOP at 08:00, 10:00, and 16:00 h was assessed at Week 2, Week 6, and Month 3. Non-inferiority of NET/LAT to BIM/TIM was defined as a difference of ≤ 1.5 mmHg at all nine time points through Month 3 and ≤ 1.0 mmHg at five or more of nine time points through Month 3. RESULTS: Overall, 430 patients were randomized (NET/LAT, n = 218; BIM/TIM, n = 212), and all received at least one dose of study medication. Efficacy analyses were performed at Month 3 on 388 patients (NET/LAT, n = 184; BIM/TIM, n = 204). NET/LAT demonstrated non-inferiority to BIM/TIM, with a between-treatment difference in IOP of ≤ 1.5 mmHg achieved at all time points and ≤ 1.0 mmHg at the majority of time points (six of nine) through Month 3. Mean diurnal IOP during the study ranged from 15.4 to 15.6 mmHg and 15.2 to 15.6 mmHg in the NET/LAT and BIM/TIM groups respectively, with no between-group statistically significant difference. No significant differences were observed in key secondary endpoints. No serious, treatment-related adverse events (AEs) were observed, and AEs were typically mild/moderate in severity. The most common treatment-related AEs were conjunctival hyperemia (NET/LAT, 30.7%; BIM/TIM, 9.0%) and cornea verticillata (NET/LAT, 11.0%; BIM/TIM, 0%). CONCLUSIONS: Once-daily NET/LAT was non-inferior to BIM/TIM in IOP reduction in OAG and OHT, with AEs consistent with previous findings. NET/LAT offers a compelling alternative FDC treatment option for OAG and OHT.

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Abstract: The bimatoprost intracameral implant (Durysta ® ) offers a sustained-release approach to glaucoma management, providing consistent intraocular pressure (IOP) reduction over several months and reducing the need for daily topical therapies. This review evaluates its pharmacology, efficacy, and safety, using data from pivotal clinical trials and recent real-world studies. The implant achieves IOP reductions comparable to topical prostaglandin analogs, with benefits for patient adherence and fewer common side effects. However, repeat administrations are associated with adverse effects such as endothelial cell loss, highlighting the need for optimized re-dosing schedules. Future research should explore its use in advanced glaucomas, cost-effectiveness, and combination with other IOP-lowering treatments. The bimatoprost intracameral implant represents a promising innovation in glaucoma therapy with potential for improved patient outcomes. Keywords: bimatoprost intracameral implant, glaucoma, intraocular pressure reduction, sustained-release therapy, primary open-angle glaucoma, ophthalmic drug delivery, patient adherence, prostaglandin analogs, endothelial cell safety, real-world evidence, cost-effectiveness, combination therapy in glaucoma

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BACKGROUND/AIMS: To compare the efficacy and safety of a new preservative-free bimatoprost 0.01%/timolol 0.1% fixed combination (BTFC) eye gel with those of bimatoprost 0.03%/timolol 0.5% fixed combination ophthalmic solution (BTFC eye drops) in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). METHODS: In this phase III, international, multi-centre, randomised, parallel group, investigator-masked study, patients receiving a first-line monotherapy, having insufficiently controlled intraocular pressure (IOP) and requiring dual therapy were randomised to receive either BTFC eye gel or BTFC eye drops once daily for 12 weeks. The primary efficacy endpoint was the change in IOP from baseline to week 12 at 08:00 in the assessed eye. Further efficacy and safety endpoints were assessed as secondary outcomes. RESULTS: The mean±SD change in IOP from baseline to week 12 at 08:00 was -10.96±3.43 mmHg for the BTFC eye gel group and -11.14±3.56 mmHg for the BTFC eye drop group. The least-squares mean difference (BTFC eye gel minus BTFC eye drops) was -0.04±0.24 mmHg (95% CI -0.51 to 0.43 mmHg), with the upper bound of the 95% CI lower than the predefined margin of +1.5 mmHg at week 12 at 08:00. Similar IOP-lowering efficacy was demonstrated at all other timepoints. The safety profile was comparable between the treatment groups. No patients in the BTFC eye gel group discontinued the study due to a treatment-related adverse event compared with 8 (2.9%) patients in the BTFC eye drop group. CONCLUSION: Low-concentration BTFC eye gel can be considered as a safe and effective treatment in the therapeutic management of glaucoma and OHT.

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Glaucoma is one of the leading causes of blindness and its prevalence increases with age. The most common form, primary open-angle glaucoma, is a chronic, slowly progressive optic neuropathy characterised by the loss of retinal ganglion cells and their axons, leading to irreversible visual field loss. Elevated intraocular pressure (IOP) is the only modifiable risk factor for glaucoma. Reducing IOP to a level that is safe for the patient's eye has been shown to slow disease progression. Lowering IOP in open-angle glaucoma is achieved by eye drops, selective laser trabeculoplasty (SLT) and/or surgery. Many patients are treated with IOP-lowering eye drops, which require lifelong continuous instillation. However, as with other chronic, asymptomatic diseases, adherence to glaucoma treatment is poor for various reasons and is associated with faster disease progression. The purpose of this review is to discuss several sustained-release systems that have been investigated to reduce IOP over time, to address barriers to adherence and improve quality of life. Among these, non-invasive drug-eluting delivery systems such as contact lenses, punctal plugs, and conjunctival ocular inserts have not reached the market. Currently, only two intracameral implants have been approved by the Food and Drug Administration for single use due to corneal safety issues. The biodegradable bimatoprost implant releases the drug continuously for 4-6 months, and its effect on IOP may extend for up to 2 years in 25% of patients. The non-biodegradable intracameral implant releases travoprost for 36 months, when it needs to be removed. However, additional data are needed to assess safety following repeated administration, as well as in broader patient populations and in combination with other treatment approaches such as SLT. Several other biodegradable intracameral implants that release prostaglandin analogues are undergoing clinical trials. In the future, intraocular implants containing genetically modified cells that secrete neurotrophic factors may potentially offer an IOP-independent neuroprotective strategy, complementing existing IOP-lowering implants in glaucoma management.

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