Ocular Hypertension and Glaucoma
Travoprost ophthalmic solution is used topically to reduce elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension who are intolerant of other IOP-lowering drugs or who have not responded adequately (i.e., failed to achieve target IOP as determined after multiple measurements over time) to another IOP-lowering drug. Travoprost has not been evaluated for the treatment of angle-closure, inflammatory, or neovascular glaucoma.
Safety and efficacy of travoprost have been evaluated in several multicenter, randomized, double-blind studies in patients with open-angle glaucoma or ocular hypertension. In these studies, which included patients with a mean baseline diurnal IOP value of 25-27 mm Hg, topical application of travoprost 0.004% once daily reduced IOP by 7-8 mm Hg. Subgroup analyses of clinical studies indicate that mean reductions in IOP may be up to 1.8 mm Hg greater in black patients than in other races. It currently is not known whether this difference is related to race or to heavily pigmented irides.
Once-daily administration of travoprost 0.004% appears to be more effective than twice-daily administration of timolol 0.5% in reducing IOP in patients with open-angle glaucoma or ocular hypertension. In several multicenter, double-blind, comparative studies, mean IOP was reduced by 7-9 or 5-8 mm Hg after 6-9 months of therapy following topical administration of travoprost 0.004% once daily or timolol 0.5% twice daily, respectively. In another study, mean IOPs appeared to be lower among patients treated with travoprost than in those treated with timolol (18-19 versus 19-20 mm Hg). Limited data indicate that travoprost 0.004% may be equally or more effective than latanoprost 0.005% in reducing IOP in patients with open-angle glaucoma or ocular hypertension. Travoprost 0.004% also appears to be superior to timolol 0.5% or latanoprost 0.005% in reducing IOP in black patients.
In one multicenter, randomized study in patients with mean baseline IOP of 24-26 mm Hg while receiving timolol 0.5%, the addition of travoprost 0.004% once daily reportedly reduced IOP by an additional 6-7 mm Hg.