Research article
Volume 13 Issue 6 - 2022
Early Results of Netarsudil for Glaucoma
Priyanka Mehta1, Kaplowitz Kevin2, Nemesure Barbara3, Lenoci Jacqueline4 and Honkanen Robert4*
1Hofstra University, Hempstead, NY, United States
2Department of Ophthalmology, Loma Linda Veterans Affairs Medical Center, Loma Linda University, Loma Linda, CA, United States
3Department of Family Population and Preventative Medicine, Stony Brook University, Stony Brook, NY, United States
4Department of Ophthalmology, Stony Brook University, Stony Brook, NY, United States
*Corresponding Author: Honkanen Robert, Associate Professor, Department of Ophthalmology, Stony Brook University, Health Science Center, Stony Brook, NY, United States.
Received: March 20, 2022; Published: May 25, 2022




Abstract

Purpose: Netarsudil, a Rho-associated protein kinase inhibitor combined with a norepinephrine transporter inhibitor, is a novel anti-glaucoma medication. Approval trials have demonstrated a reduction in the intraocular pressure (IOP), but phase IV data has been sparse. This study was designed to provide real-world efficacy and safety data for netarsudil in clinical use.

Methods: A single center retrospective review at a University Hospital outpatient clinic was performed to assess the pressure-lowering effect of netarsudil 0.02% on patients with glaucoma. We included all patients who were treated with netarsudil at our institution. Exclusion criteria included less than one month of follow-up. The indication for adding netarsudil 0.02% at bedtime was determined on a case-by-case basis by the treating glaucoma specialist. The main outcome measure was the change in intraocular pressure (IOP) following the addition of netarsudil. The secondary outcome measure was the rate of adverse events throughout the 6-month treatment period.

Results: A total of 147 patients were started on netarsudil. The average age was 72 +/- 12 years old. The mean baseline IOP was 20.1 +/- 6.5 mmHg. After 6 months, the mean IOP had decreased 5 mmHg to 15.1 +/- 5.1 mmHg, a 25% reduction, while 44% achieved an IOP < 14 mmHg. The mean number of medications was similar at 3.8 +/- 1 medications at baseline and 3.6 +/- 1 at 6 months. Adverse events occurred in 60 patients (41%). The most common adverse event was conjunctival hyperemia which occurred in 19%, followed by dryness in 19%.

Conclusion: Adding netarsudil to a group of patients on previously core topical therapy still reduced the IOP at 6 months by a mean of 25%. Netarsudil was effective as an additive treatment to patients on multiple medications.

Keywords: Netarsudil; Rho Kinase Inhibitor; Norepinephrine Transporter Inhibitor; Glaucoma

References

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  2. Li G., et al. “Visualization of conventional outflow tissue responses to netarsudil in living mouse eyes”. European Journal of Pharmacology 787 (2016): 20-31.
  3. Wang R-F., et al. “Effect of 0.04% AR-13324, a ROCK, and norepinephrine transporter inhibitor, on aqueous humor dynamics in normotensive monkey eyes”. Journal of Glaucoma 1 (2015): 51-54.
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  6. Serle JB., et al. “Two Phase 3 Clinical Trials Comparing the Safety and Efficacy of Netarsudil to Timolol in Patients with Elevated Intraocular Pressure: Rho Kinase Elevated IOP Treatment Trial 1 and 2 (ROCKET-1 and ROCKET-2)”. American Journal of Ophthalmology 186 (2018): 116-127.
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  8. Watabe H., et al. “Effects of Rho-associated protein kinase inhibitors Y-27632 and Y-39983 on isolated rabbit ciliary arteries”. Japanese Journal of Ophthalmology 4 (2011): 411-417.
  9. Kahook MY., et al. “Long-term Safety and Ocular Hypotensive Efficacy Evaluation of Netarsudil Ophthalmic Solution: Rho Kinase Elevated IOP Treatment Trial (ROCKET-2)”. American Journal of Ophthalmology 200 (2019): 130-137.
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Citation: Honkanen Robert., et al. “Early Results of Netarsudil for Glaucoma”. EC Ophthalmology 13.5 (2022): 18-23.

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