OBJECTIVE: To compare the effectiveness of brinzolamide (Azopt®) and brimonidine (Alphagan®) in the treatment of glaucoma according to the data collected in the United-Kingdom General Practitioner Research Database (UK-GPRD). METHODS: Files with a diagnosis of ocular hypertension, or glaucoma, or treated with a topical treatment surgery or laser were extracted. Patients with prescription for brimonidine or dorzolamide mono-therapy were selected regardless of treatment line (initial, second line, third, etc.). Treatment failure was defined as a prescription change (adding or removing a topical treatment). Time to treatment failure was compared using an adjusted Cox model. Adjustment for confounding factors used the propensity score method. RESULTS: A total of 56,612 patients were extracted and 39,808 patients had at least one topical prescription for glaucoma. A total of 2,175 were treated with brimonidine and 482 with brinzolamide monotherapy. No significant difference in the characteristics of the patients was found. Patients were 69.5 years old on average at diagnosis and 46.5% were male. At one year, 54.4% of the brimonidine patients had a treatment failure versus 42.3% with brinzolamide (P<0.001). The hazard ratio for a failure was 0.798 (P<0.001) lower with brinzolamide, after adjusting for age, gender, and comorbidities. CONCLUSION According to the UK-GPRD information, brinzolamide is more efficient than brimonidine in the treatment of glaucoma patients, in mono-therapy, in all treatment lines. Patients remained treated longer with brinzolamide.