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Objective: To evaluate open-angle glaucoma patients, who were insufficiently controlled on latanoprost mono- therapy, to determine the 24 h intraocular pressure (lOP) efficacy and safety when changing them to dorzolamide/timolol (DTFC) or latanoprost/timolol fixed combination (LTFC) or adding DTFC. Methods: A prospective, observer-masked, placebo-controlled, crossover, comparison. Consecutive adults with primary open-angle or exfoliative glaucoma who exhibit a mean baseline lOP >21 mm Hg on latanoprost monotherapy were randomised for 3 months to: OTFC, LTFC or DTFC and latanoprost. Patients were then crossed over to the next treatment for periods 2 and 3. At the end of the latanoprost run-in and after each 3-month treatment period, patients underwent 24 h lOP monitoring. Results: 31 patients completed this study. All three adjunctive therapies significantly reduced the lOP at each time point and for the mean 24 h curve, except at 18:00 and 02:00 with DTFC and 02:00 with LTFC. When the three treatments were compared directly, the DTFC and latanoprost therapy demonstrated lower lOPs versus the other treatment groups, including: the mean 24 h pressure, maximum as well as minimum levels and individual time points following a modified Bonferroni correction (p<0.0032). Conclusions: This study showed DTFC, LTFC and the addition of DTFC to latanoprost significantly decrease the lOP compared with latanoprost alone, but the latter therapy regime yields the greatest OP reduction. [ABSTRACT FROM AUTHOR]

This multicenter, factorial-design trial assessed the safety and additive antihypertensive efficacy of a slow-release (SR) formulation of diltiazem hydrochloride given alone or in combination with hydrochlorothiazide for treatment of mild to moderate hypertension. After a 4- to 6-week placebo run-in period, 297 qualifying patients were randomized to receive placebo, 1 of 4 doses of diltiazem SR monotherapy, 1 of 3 doses of hydrochlorothiazide monotherapy, or 1 of 12 possible combinations of diltiazem SR and hydrochlorothiazide for 6 weeks. A dose-related reduction in blood pressure was demonstrated for each drug as monotherapy and for the two drugs in combination. Absolute blood pressures of patients who received combination therapy were lower by an overall mean of 3.0 mm Hg diastolic and 8.0 mm Hg systolic vs diltiazem SR used alone and 3.5 mm Hg diastolic and 4.0 mm Hg systolic vs hydrochlorothiazide used alone. At the largest doses used, 50% of patients achieved goal blood pressure while taking hydrochlorothiazide, 57% while taking diltiazem SR, and 75% while taking combination therapy. Combination therapy was well tolerated. This trial clearly demonstrates that diltiazem SR and hydrochlorothiazide have additive antihypertensive effects. [ABSTRACT FROM AUTHOR]

The authors discuss the article "Risk of Intracranial Haemorrhage in Anti-Depressant Users With Concurrent Use of Non-steroidal Anti-Inflammatory Drugs: Nationwide Propensity Score Matched Study," by Ju-Yong Shin and colleagues which appeared in the same issue. Topics include the relation between antidepressant drugs, non-steroidal anti-inflammatory drugs (NSAIDs), and intracranial hemorrhage, the risk of bleeds when the two classes of drugs are combined, and clinical implications.