Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety

Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40-80. The best way to manage primary open-angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medica...

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Published in:	Indian journal of ophthalmology Vol. 71; no. 6; pp. 2500 - 2503
Main Authors:	Mathur, Manoj, Ratnam, P, Saikumar, S, John, Manuel, Ravishankar, Siddharth, Dinesh, M, Chandil, Priya, Pahuja, Kishore, Cherlikar, Vidya, Wadhwani, Sunny, Bendale, Pankaj, Hazari, Ajit, Mishra, Rajesh, Deshmukh, Susheel, Achlerkar, Rahul, Shah, Devang, Hingorani, Chanda, Shah, Kaivan, Topiwala, Pratik, Jani, Sheetal, Rana, Viral, Majumdar, Nilay, Chakrabarti, Debasis, Dey, Rituparna, Halder, Debabrata, Choudhury, Sumit, Kumar, Ajeet, Das, Sasmita, Nanda, Ashok, Kumar, Vidya, Dubey, Rama, Kamdar, Gulam, Pandey, Alka, Kishanpuria, Sheetal, Srivastava, Rajat, Singh, Parul, Verma, Sunil, Sharma, Neha, Gupta, Rajeev
Format:	Journal Article
Language:	English
Published:	India Wolters Kluwer India Pvt. Ltd 01-06-2023 Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd Wolters Kluwer - Medknow Wolters Kluwer Medknow Publications
Subjects:	Acuity Antihypertensive Agents - therapeutic use Blindness Care and treatment Development and progression Dosage Drug-Related Side Effects and Adverse Reactions - drug therapy Extracellular matrix Glaucoma Glaucoma - drug therapy Glaucoma, Open-Angle Humans Hypertension Intraocular Pressure iop Irritation netarsudil ocular hypertension Ocular Hypertension - diagnosis Ophthalmic Solutions Original Prevention rho kinase inhibitors Rho-associated kinase Risk factors Side effects Treatment Outcome India Glaucoma netarsudil ocular hypertension IOP Rho kinase inhibitors
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Summary:	Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40-80. The best way to manage primary open-angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open-label, real-world, multicentric, observation-based 3-month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first-line therapy. Diurnal IOP measurements, best-corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day-1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty-nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once-daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first-line treatment in primary open-angle glaucoma and ocular hypertension was both safe and effective.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0301-4738 1998-3689
DOI:	10.4103/IJO.IJO_25_23