Skip to main content

Advertisement

SpringerLink
Log in

The effectiveness and tolerability of fixed-dose combination netarsudil 0.02%/latanoprost 0.005% at a tertiary glaucoma center

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To assess real-world effectiveness and tolerability of fixed-dose combination netarsudil 0.02%/latanoprost 0.005% (FCNL) in management of glaucoma patients in a tertiary eye care center.

Methods

This retrospective cohort study included glaucoma patients initiated on FCNL from January 2018 to July 2021 with at least 1-month follow-up. Demographic and clinical data were collected at baseline and at follow-up visits through 12 months. Patient-solicited side effects were recorded at each visit. Maximum glaucoma pharmacotherapy was defined as surgery/laser being the next treatment option following an intensive pharmacotherapy regimen, or when pharmacotherapy could not be increased due to allergy/intolerance or all pharmacologic mechanisms already being in use.

Results

Seventy-nine eyes of 47 patients were included. Mean age was 67.7 ± 14.7 years. Baseline IOP was 18.7 ± 4.9 mmHg; mean change in IOP (∆IOP) each study visit compared to baseline ranged from − 1.6 ± 3.5 to − 4.4 ± 4.1 mmHg (all p < 0.05). The eyes on maximum glaucoma pharmacotherapy (73.4%) had similar ∆IOP compared to those on non-maximal therapy at each visit (p > 0.2 for all). Forty-three (54.4%) eyes were switched from a prostaglandin analog alone, producing a 1-month IOP reduction of − 4.7 ± 3.9 mmHg at 1 month which remained significant at each visit for the 12-month study period (all p < 0.05). Across all study visits, conjunctival hyperemia was documented in 26 (32.9%) eyes. Subjective blurry vision was reported in 22 (27.8%) eyes without significant worsening of visual acuity at any visit (all p > 0.05). Six (7.6%) and 7 (8.9%) eyes required further medical or surgical/laser intervention, respectively. Kaplan–Meier analysis revealed no significant difference in the need for subsequent medical or surgical intervention between those on maximum and non-maximal pharmacotherapy (p > 0.4).

Conclusion

FCNL was well-tolerated and demonstrated a significant and sustained reduction in IOP, even as last-line therapy before incisional or laser surgery in those on maximum glaucoma pharmacotherapy. FCNL is a viable treatment option for glaucomatous eyes before consideration of surgical intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Resnikoff S, Pascolini D, Etya’ale D et al (2004) Global data on visual impairment in the year 2002. Bull World Health Organ 82:844–851

    Google Scholar 

  2. Leske MC, Heijl A, Hussein M et al (2003) Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol (Chicago Ill: 1960) 121:48–56. https://doi.org/10.1001/archopht.121.1.48

    Article  Google Scholar 

  3. Kass MA, Heuer DK, Higginbotham EJ et al (2002) The Ocular hypertension treatment study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol (Chicago Ill: 1960) 120:701–713. https://doi.org/10.1001/archopht.120.6.701

    Article  Google Scholar 

  4. Anderson DR (2003) Collaborative normal tension glaucoma study. Curr Opin Ophthalmol 14:86–90. https://doi.org/10.1097/00055735-200304000-00006

    Article  Google Scholar 

  5. Sturdivant JM, Royalty SM, Lin CW et al (2016) Discovery of the ROCK inhibitor netarsudil for the treatment of open-angle glaucoma. Bioorg Med Chem Lett 26:2475–2480. https://doi.org/10.1016/j.bmcl.2016.03.104

    Article  CAS  Google Scholar 

  6. Rao VP, Epstein DL (2007) Rho GTPase/Rho kinase inhibition as a novel target for the treatment of glaucoma. BioDrugs 21:167–177. https://doi.org/10.2165/00063030-200721030-00004

  7. Rao PV, Deng PF, Kumar J, Epstein DL (2001) Modulation of aqueous humor outflow facility by the Rho kinase-specific inhibitor Y-27632. Invest Ophthalmol Vis Sci 42:1029–1037

    CAS  Google Scholar 

  8. Tanna AP, Johnson M (2018) Rho kinase inhibitors as a novel treatment for glaucoma and ocular hypertension. Ophthalmology 125:1741–1756. https://doi.org/10.1016/j.ophtha.2018.04.040

    Article  Google Scholar 

  9. Serle JB, Katz LJ, McLaurin E et al (2018) 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). Am J Ophthalmol 186:116–127. https://doi.org/10.1016/j.ajo.2017.11.019

    Article  CAS  Google Scholar 

  10. Lewis RA, Levy B, Ramirez N et al (2016) Fixed-dose combination of AR-13324 and latanoprost: a double-masked, 28-day, randomised, controlled study in patients with open-angle glaucoma or ocular hypertension. Br J Ophthalmol 100:339–344. https://doi.org/10.1136/bjophthalmol-2015-306778

    Article  Google Scholar 

  11. Bacharach J, Dubiner HB, Levy B et al (2015) Double-masked, randomized, dose-response study of AR-13324 versus latanoprost in patients with elevated intraocular pressure. Ophthalmology 122:302–307. https://doi.org/10.1016/j.ophtha.2014.08.022

    Article  Google Scholar 

  12. Asrani S, Bacharach J, Holland E et al (2020) Fixed-dose combination of netarsudil and latanoprost in ocular hypertension and open-angle glaucoma: pooled efficacy/safety analysis of phase 3 MERCURY-1 and -2. Adv Ther 37:1620–1631. https://doi.org/10.1007/s12325-020-01277-2

    Article  CAS  Google Scholar 

  13. Brubaker JW, Teymoorian S, Lewis RA et al (2020) One year of netarsudil and latanoprost fixed-dose combination for elevated intraocular pressure: phase 3, randomized MERCURY-1 study. Ophthalmol Glaucoma 3:327–338. https://doi.org/10.1016/j.ogla.2020.05.008

    Article  Google Scholar 

  14. Asrani S, Robin AL, Serle JB et al (2019) Netarsudil/latanoprost fixed-dose combination for elevated intraocular pressure: Three-Month Data from a Randomized Phase 3 Trial. Am J Ophthalmol 207:248–257. https://doi.org/10.1016/j.ajo.2019.06.016

    Article  CAS  Google Scholar 

  15. Steven DW, Alaghband P, Lim KS (2018) Preservatives in glaucoma medication. Br J Ophthalmol 102:1497–1503. https://doi.org/10.1136/bjophthalmol-2017-311544

    Article  Google Scholar 

  16. Wisely CE, Sheng H, Heah T, Kim T (2020) Effects of netarsudil and latanoprost alone and in fixed combination on corneal endothelium and corneal thickness: post-hoc analysis of MERCURY-2. Adv Ther 37:1114–1123. https://doi.org/10.1007/s12325-020-01227-y

    Article  CAS  Google Scholar 

  17. Shiuey EJ, Mehran NA, Ustaoglu M et al (2022) The effectiveness and safety profile of netarsudil 0.02% in glaucoma treatment: real-world 6-month outcomes. Graefes Arch Clin Exp Ophthalmol 260:967–974. https://doi.org/10.1007/s00417-021-05410-x

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Suite 1100, Philadelphia, PA, 19107, USA

    Jae-Chiang Wong, Reza Razeghinejad, Aakriti G. Shukla, Natasha N. Kolomeyer, Jonathan S. Myers, Michael J. Pro & Daniel Lee

  2. Rowan University School of Osteopathic Medicine, Stratford, NJ, USA

    Jae-Chiang Wong

  3. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Eric J. Shiuey, Reza Razeghinejad, Aakriti G. Shukla, Natasha N. Kolomeyer, Jonathan S. Myers, Michael J. Pro & Daniel Lee

Authors
  1. Jae-Chiang Wong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eric J. Shiuey
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Reza Razeghinejad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aakriti G. Shukla
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Natasha N. Kolomeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jonathan S. Myers
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael J. Pro
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Daniel Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel Lee.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board at Wills Eye Hospital (Philadelphia, Pennsylvania, USA) and with the Declaration of Helsinki 1964 and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

NNK received research support from AbbVie/Allergan, Guardion Health Services Inc., Equinox, Nicox, Olleyes, Santen, Glaukos, Diopsys, and Aerie, and consulting fees from AbbVie/Allergan (myself, spouse), Regeneron (spouse), Alimera (spouse), and Genentech (spouse). AGS has received research support from AbbVie, Inc., and consulting fees from AbbVie, Inc., and also participates on a Data Safety Monitoring Board or Advisory Board for AbbVie, Inc. RR received research support from Olleyes, Equinox, and Allergan. DL has received research support from Allergan, Equinox, Glaukos, Mati, Nicox, Olleyes, and Santan, lecture fees from Glaukos, and consulting fees from Quidel Eye Health. JW, EJS, JSM, and MJP declare they have no financial disclosures.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wong, JC., Shiuey, E.J., Razeghinejad, R. et al. The effectiveness and tolerability of fixed-dose combination netarsudil 0.02%/latanoprost 0.005% at a tertiary glaucoma center. Graefes Arch Clin Exp Ophthalmol 261, 193–200 (2023). https://doi.org/10.1007/s00417-022-05780-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-022-05780-w

Keywords

Search

Navigation