Evaluation of Generic versus Original Prostaglandin Analogues in the Treatment of Glaucoma: A Systematic Review and Meta-Analysis

Alvilda T. Steensberg, Olivia O. Müllertz, Gianni Virgili, Augusto Azuara-Blanco, Miriam Kolko

Research output: Contribution to journalReview articlepeer-review


Topic: An evaluation of the efficacy and tolerability of generic prostaglandin analogues (PGAs) compared with their original counterpart. Clinical Relevance: This systematic review was initiated to enlighten ophthalmologists and patients in the use of original and generic ophthalmic solutions. Methods: A literature search was conducted on PubMed, EMBASE, MEDLINE, Clinicaltrials.gov, and the World Health Organization International Clinical Trials Registry Platform, along with a manual search, from the marketing of the first PGA, latanoprost, in 1995 to the present. Randomized controlled trials comparing an original PGA with its generic counterpart were included. The last literature search was conducted in June 2019. Risk of bias was assessed by 2 independent reviewers using the Cochrane Handbook for Systematic Reviews Tool. The primary outcome was reduction of intraocular pressure (IOP) from baseline. Secondary outcomes included tolerability, ocular surface health, quality of life, disease progression, and cost-effectiveness. Meta-analysis of the primary outcome was planned. Results: Of 385 screened articles, 6 were included in a broad characterization and in the meta-analysis. A total of 619 patients were enrolled. The duration of the studies ranged from 3 to 16 weeks. Meta-analysis of all 6 studies denied any clinically significant difference in efficacy, and the 95% confidence interval included nil (-0.50 to 0.04 mmHg). The evidence was of moderate certainty because of unclear or high risk of bias in all studies. There were no reported differences in tolerability. Conclusions: Trials comparing original and generic PGAs did not show a clinically significant difference in IOP-lowering effect or tolerability. However, the quality of the trials is suboptimal. Overall, there is uncertainty, and further research is needed to confirm equivalence.
Original languageEnglish
Pages (from-to)51-59
Number of pages9
JournalOphthalmology. Glaucoma
Issue number1
Early online date02 Nov 2019
Publication statusPublished - 01 Jan 2020

Bibliographical note

Publisher Copyright:
Copyright © 2019 American Academy of Ophthalmology. All rights reserved.

This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

ASJC Scopus subject areas

  • Medicine(all)


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