{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:39:08Z","timestamp":1793093948123,"version":"4.5.0"},"reference-count":45,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Ocular Pharmacology and Therapeutics"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To compare the efficacy, tolerability, and persistence of a fixed triple combination (FTC) of bimatoprost 0.01%\/brimonidine tartrate 0.15%\/timolol maleate 0.5% with the same agents administered separately. Secondary outcomes included adverse effects, quality of life (QoL), and adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This randomized clinical trial included 46 patients with primary open-angle (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 36) or primary angle-closure glaucoma (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 10) requiring three or more hypotensive agents. After a washout period, participants were randomized to FTC twice daily or to bimatoprost 0.03% once, brimonidine 0.2%, and timolol 0.5% twice daily. Examinations at 1, 4, and 6 months included conjunctival hyperemia grading, tear break-up time, corneal staining, and validated questionnaires assessing QoL, ocular surface, and adherence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean age was 65.0 \u00b1 11.5 years; baseline mean deviation \u201311.94 \u00b1 8.72 dB, and prior treatment 3.9 \u00b1 2.5 years. Both regimens significantly reduced intraocular pressure (FTC group: 24.37 \u00b1 5.92 to 15.42 \u00b1 2.69 mmHg; unfixed group: 26.18 \u00b1 6.79 to 14.53 \u00b1 3.49 mmHg;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), with no difference between groups. Hyperemia worsened (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.009), QoL declined (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and adherence remained stable. Discontinuation reached 63%, mainly from disease progression (34.5%) and intolerance (27.6%). Survival analysis showed a 69.6% probability of treatment maintenance at 6 months. Among completers, 61.8% had worsening hyperemia (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004), whereas discontinuers exhibited QoL decline (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). In FTC, the visual field deteriorated in the discontinued group (\u0394\u20131.11;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.025).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Both regimens achieved similar efficacy but were associated with progressive hyperemia, reduced QoL, and low persistence, underscoring the limitations of multiple topical glaucoma therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10807683261421428","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T11:40:54Z","timestamp":1772019654000},"page":"289-298","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Fixed Triple-Combination Bimatoprost\/Brimonidine\/Timolol Versus Separate Administration in Glaucoma: Randomized Clinical Trial"],"prefix":"10.1177","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4259-5244","authenticated-orcid":false,"given":"Lilian F.","family":"Machado","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Visual Science, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Kawamuro","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Science, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Bando","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Science, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucca","family":"Sokabe","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Science, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Parmigiani","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Science, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Science, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Yuji Abe","sequence":"additional","affiliation":[{"name":"Hospital Oftalmol\u00f3gico de Bras\u00edlia, Federal District, 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