Clinical success and quality of life with brimonidine 0.2% or Timolol 0.5% used twice daily in glaucoma or ocular hypertension: A randomized clinical trial

J. C. Javitt, R. M. Schiffman, W. Atlas, K. J. Baum, D. L. Cookem, H. B. DuBiner, J. L. Katz, T. Kupin, J. E. Memmen, T. K. Mundorf, E. Nelson, H. Offenberg, H. I. Schenker, E. Sharpe, D. Stevenson, W. C. Stewart, N. Tanchel, R. Whitaker

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Purpose: To compare the clinical success rates and quality of life impact of brimonidine 0.2% with timolol 0.5% in newly diagnosed patients naive to glaucoma therapy. Methods: A prospective, multicenter, randomized, double-masked, clinical effectiveness trial in which the clinical outcomes of twice daily brimonidine tartrate 0.2% were compared with those of timolol maleate 0.5% in patients with glaucoma and ocular hypertension was conducted. Two hundred nineteen patients were enrolled - 111 in the brimonidine group and 108 in the timolol group. Patients instilled their study medications twice daily for 4 months. Factors for determining clinical success were reduction of intraocular pressure (IOP), safety, and adverse events. Quality of life effects were assessed with the SF-36 Health Survey and Glaucoma Disability Index questionnaires. Results: Clinical success was 71% (75/106) with brimonidine and 70% (73/105) with timolol as initial treatment. The overall mean decrease in lOP was 6.5 mm Hg with brimonidine and 6.2 mm Hg with timolol. Few patients reported a specific adverse event and, with the exception of a slightly higher rate of ocular burning and stinging in the brimonidine group, there were no significant between-group differences. No significant chronotropic effects on the heart were seen with brimonidine, while small but significant mean decreases in heart rate were seen at months 1 and 4 with timolol. Mean systolic and diastolic blood pressure remained relatively stable in both groups. Quality of life remained stable, with no significant between-group differences. Conclusions: As a first-line agent for the treatment of glaucoma and ocular hypertension, brimonidine has clinical effectiveness equivalent to timolol, but with less chronotropic effect on the heart. Brimonidine is a viable alternative to timolol for first-line therapy in glaucoma and ocular hypertension.

Original languageEnglish (US)
Pages (from-to)224-234
Number of pages11
JournalJournal of glaucoma
Issue number3
StatePublished - Jan 1 2000
Externally publishedYes


  • Alphagan
  • Brimonidine
  • Clinical effectiveness
  • Glaucoma Disability Index
  • Quality of life
  • Timolol
  • Timoptic

ASJC Scopus subject areas

  • Ophthalmology


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