Brimonidine 3mg/g gel

Topical interventions for rosacea are often used to relieve local symptoms. However, currently, there are few articles to systematically analyze the efficacy profile of topical drugs for rosacea. This study aimed to investigate the efficacy profile of widely used topical drugs. To acquire appropriate information from related literature, we looked into 4 databases. Efficacy was appraised with the Investigator Global Assessment, Clinician's Erythema Assessment, Patient's Self-Assessment and Subject Self-Assessment of Rosacea Facial Redness scales. Treatment-emergent adverse events and dermal tolerability were also recorded. According to 21 randomized controlled trials included, a total of 6 topical drugs including minocycline, ivermectin, azelaic acid, metronidazole, brimonidine and oxymetazoline were reported. These drugs are well-tolerated and safe. Ivermectin is more effective than azelaic acid and metronidazole. Azelaic acid has a better efficacy profile than metronidazole according to included studies. Minocycline turned out to be effective improving the symptoms of rosacea. Brimonidine and oxymetazoline both have significant effects on reducing facial redness.

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The objectives of the study were to compare the efficacy and safety using ocular surface assessment between preserved and preservative-free brimonidine/timolol fixed-combination eye drops in glaucoma or ocular hypertension patients. Methods: This study was designed as a prospective, multicenter (three institutions), investigator-masked, parallel-grouped randomized clinical trial. The primary outcomes were corneal and conjunctival staining score, ocular surface disease index (OSDI) score, drug tolerance, and adherence rates at 12-week visits. The secondary outcomes were corneal and conjunctival staining score, OSDI score at 4-week visits and intraocular pressure (IOP), tear-film break-up time (TBUT), and bulbar/limbal hyperemia score at the 4- and 12-week visits. For safety assessment, best-corrected visual acuity (BCVA), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and physical examination at 4 and 12 weeks and adverse events during the whole study period were analyzed. Results: Overall, 59 patients were enrolled and randomized into each group (29 preserved and 30 preservative-free). At the endpoint, 5 patients in the preserved group and 2 patients in the preservative-free group dropped out, leaving 24 and 28 patients in the preserved and preservative-free groups, respectively. Baseline characteristics showed no significant difference between the groups including age and sex. At the 12-week visit, intra-group change of OSDI scores did not change significantly compared to the baseline scores in both preserved and preservative-free groups (p = 0.791, 0.478, respectively). On the contrary, the corneal staining score and the conjunctival staining score showed a significant increase compared to the baseline score in the preserved group (p = 0.015, 0.009, respectively). Regarding drug satisfaction, higher proportions of patients in the preservative-free group reported convenience of installation (p = 0.002). Also, stinging and burning sensations in drug tolerance showed better results in the preservative-free group with a significant difference (p = 0.011). Safety assessment regarding systemic side effects such as SBP, DBP, and HR showed similar results between the preserved and preservative-free groups (p = 0.711, 0.232, 0.666, respectively). Conclusions: Preservative-free brimonidine/timolol showed comparable efficacy and safety, better corneal and conjunctival staining score with convenience of installation, and lower stinging and burning sensation. It is expected to be a proper treatment option for patients with glaucoma or ocular hypertension.

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IntroductionIntravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents are a primary management option for retinal diseases. Acute elevation of intraocular pressure (IOP) is a complication associated with these injections that should be considered. This study investigated and compared the prophylactic effects of fixed combination anti-glaucoma medication on IOP spikes following intravitreal anti-VEGF injections.MethodsThis randomized double-blind clinical trial included one eye of each participant indicated for treatment with intravitreal injection of anti-VEGF agents (bevacizumab, aflibercept, and ranibizumab) and randomly allocated to one of the three prophylactic anti-glaucoma medications, with each drug further divided into one- and two-drop regimens before intravitreal injection. Participants with allergies or contraindications to medications were excluded from the pretreatment groups and were invited to participate in the control group.ResultsThe study involved 308 participants: 89 in the dorzolamide/timolol group, 86 in the brimonidine/timolol group, 101 in the brinzolamide/brimonidine group, and 32 in the control group. Baseline characteristics and IOP were comparable across all groups. In the prophylactic premedication groups, mean IOP at 30 min were within 21 mmHg and returned to their baseline at 1 h. Mean IOP measurements between baseline and 30 min in the brimonidine/timolol two-drop regimen were not significantly different: 13.72 ± 4.63 vs 15.11 ± 4.39 mmHg, p = 0.096. In the control group, IOP significantly increased from baseline at 30 min and 1 h post-injection: 14.31 ± 4.10, 22.15 ± 8.64, and 18.36 ± 7.52 mmHg, respectively, p ConclusionTopical fixed combination anti-glaucoma medication used as a prophylactic treatment before intravitreal anti-VEGF injections significantly prevented IOP spikes post-injection, with a comparable effect among three medications. Prophylactic treatment of IOP spikes should be considered as standard care to prevent further damage in patients with compromised retinal vascular and optic nerve perfusion.Trial registrationTCTR20241005001, retrospectively registered.

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Posterior capsule opacification (PCO) is a common post-cataract surgery complication treated with Nd:YAG laser posterior capsulotomy, which may cause intraocular pressure (IOP) spikes and threaten vision. Brimonidine and apraclonidine are widely used to prevent such elevations. This prospective, double-masked, randomized clinical trial evaluated the efficacy of topical dexmedetomidine, a novel ophthalmic drop, in preventing IOP rise after Nd:YAG laser treatment. A total of 111 eyes from 89 pseudophakic patients were randomized to receive dexmedetomidine 0.008% or brimonidine 0.2% one h before the procedure. Patients with glaucoma, baseline IOP > 24 mmHg, keratoconus, corneal edema, prior refractive/corneal surgery, or unstable cardiovascular disease were excluded. IOP was measured with air-puff tonometry at baseline, 30 min, 4 h, and 24 h post-laser. Baseline characteristics were comparable. In the dexmedetomidine group, mean IOP values were 16.3 ± 3.6, 14.8 ± 4.7, 17.1 ± 6.2, and 16.7 ± 4.5 mmHg, while in the brimonidine group, they were 16.7 ± 2.9, 13.3 ± 3.9, 13.2 ± 5.5, and 14.2 ± 3.9 mmHg, respectively. At 30 min, brimonidine significantly reduced IOP (p = 0.000), whereas dexmedetomidine did not (p = 0.116). At 4 and 24 h, IOP increased above baseline with dexmedetomidine but decreased with brimonidine (p = 0.001 and p = 0.004). Dexmedetomidine was associated with more IOP spikes > 10 mmHg (9% vs. 2%, p = 0.035) and IOP > 30 mmHg (7% vs. 2%, p = 0.09). No systemic or ocular side effects occurred. Although dexmedetomidine prevented acute IOP surges, its efficacy was inferior to brimonidine. Further studies should explore optimal dosing, formulations, and long-term safety to clarify its prophylactic potential.

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Presbyopia is a progressive, irreversible age-related decline in ocular accommodation caused by reduced lens elasticity, resulting in impaired near vision and a significant impact on daily activities and quality of life. Globally, presbyopia affects approximately 1.8 billion individuals, with projections rising to 2.1 billion by 2030. Current management options include spectacles, contact lenses, pharmacologic agents such as pilocarpine, and surgical interventions; however, each approach carries limitations related to convenience, adaptability, or visual compromise. Yuvezzi™ (carbachol 2.75% and brimonidine tartrate 0.1%) is a recently U.S. Food and Drug Administration (FDA)-approved dual-agent ophthalmic solution designed to improve near vision through pharmacologically induced miosis. Carbachol, a parasympathomimetic agent, stimulates muscarinic receptors to produce sustained pupillary constriction, while brimonidine, an α2-adrenergic agonist, inhibits iris dilator activity and prolongs the miotic effect, enhancing tolerability. Its approval was based on two Phase 3 randomized controlled trials, BRIO-I and BRIO-II, which demonstrated significant improvement in binocular uncorrected near visual acuity without compromising distance vision. Common adverse effects included ocular discomfort, irritation, visual disturbances, and headache. Yuvezzi™ offers a noninvasive, reversible alternative for presbyopia management; however, long-term safety and sustained efficacy require further evaluation.

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Background/Objectives: Rho-associated protein kinase inhibitors reduce intraocular pressure (IOP) by enhancing aqueous humor outflow through the trabecular meshwork-Schlemm's canal pathway. However, it remains unclear whether the fixed-dose combination of ripasudil hydrochloride hydrate and brimonidine tartrate (GLAALPHA) enhances conventional aqueous outflow in vivo. Methods: This single-center randomized clinical trial included healthy adult volunteers who received GLAALPHA, a brimonidine tartrate-brinzolamide fixed-dose combination (Ailamide), or brimonidine tartrate monotherapy (Aiphagan) in a crossover sequence. The aqueous column width in the episcleral veins was assessed at baseline and at 2 h (primary outcome) and 8 h using hemoglobin video imaging. Results: Among 24 participants, analyses included 23 GLAALPHA-treated eyes, 21 Ailamide-treated eyes, and 22 Aiphagan-treated eyes. Two hours after instillation, the aqueous column width significantly increased from baseline only in the GLAALPHA group (p = 0.002). The percent increase in the aqueous column width at 2 h was significantly greater with GLAALPHA than with Ailamide (p = 0.039) and not significantly different between GLAALPHA and Aiphagan (p = 0.114). At 8 h, the aqueous column width did not differ from the baseline in any groups. Conclusions: In healthy adult eyes, GLAALPHA significantly increased the aqueous column width in the episcleral veins 2 h after instillation, indicating enhanced conventional aqueous outflow. These findings provide evidence that GLAALPHA promotes trabecular outflow beyond the effects of brimonidine tartrate-containing comparators and offer mechanistic insights into its action.

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