Effectiveness of Netarsudil as an Additional Therapy for Glaucoma in Patients Already on Maximally Tolerated Medical Therapy

Villegas, Natacha C; Lee, Wen-shin

doi:10.2147/opth.s337105

Cited by 11 publications

(21 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently published retrospective studies of patients in academic glaucoma practices with baseline intraocular pressures between 18 and 20 mmHg (range, 18.47 to 20.3 mmHg) showed an absolute intraocular pressure reduction of 3.0 to 3.9 mmHg reduction (or 16 to 20.9% reduction). [8][9][10][11][12] The reduction of intraocular pressure from netarsudil addition seems to be proportional to the baseline intraocular pressure. In a study with baseline intraocular pressure of 17 mmHg, the absolute intraocular pressure reduction was lower (2.2 mmHg or 13% reduction) after adding netarsudil compared with other studies with higher baseline intraocular pressure.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Effectiveness of Topical ρ-Kinase Inhibitors in Veterans with Severe Glaucoma on Maximally Tolerated Medical Therapy

et al. 2022

View full text Add to dashboard Cite

SIGNIFICANCE:The real-world pharmacological use of netarsudil shows that it can produce a clinically significant decrease in intraocular pressure for a small group of patients, even if they are already taking three or four other hypotensive glaucoma medication classes.PURPOSE: This study aimed to assess the effectiveness of netarsudil in reducing intraocular pressure among veterans with advanced glaucoma on maximally tolerated medical therapy.METHODS: All patients with glaucoma who received netarsudil between June 2018 and April 2020 from the West Los Angeles Veterans Administration Medical Center were reviewed. Inclusion criteria included a minimum of one intraocular pressure measurement in each of two time windows (within and after 4 months of netarsudil use). Exclusion criteria included medication nonadherence, change in treatment plan before post-treatment intraocular pressure could be obtained, corneal disease precluding reliable measurement, outside follow-up, and loss to follow-up. Intraocular pressure at baseline and that at two time windows were compared using analyses of variance. Relationships between intraocular pressure and number of baseline medications and concurrent statin therapy were evaluated. Netarsudil tolerability was reported. RESULTS:Of 200 patients prescribed netarsudil, 42 patients (eyes) met the enrollment criteria. The mean age of these patients was 75.7 years (95% confidence interval [CI], 73.0 to 78.4 years), 64% were of African descent, 79% had open-angle glaucoma, and the mean number of baseline medications was 3.7 (95% CI, 3.5 to 3.9). Baseline intraocular pressure of 17.2 mmHg (95% CI, 16.1 to 18.2 mmHg) decreased to 15.1 mmHg (95% CI, 14.0 to 16.2 mmHg; P < .001), and a reduction of >20% was seen in 30.9% of patient after 4 months of netarsudil therapy. Intraocular pressure reduction was not associated with number of baseline medications or systemic statin use. CONCLUSIONS:Netarsudil may produce a clinically significant intraocular pressure reduction in up to a third of the patients with advanced glaucoma already on maximally tolerated medical therapy.

show abstract

Section: Discussionmentioning

confidence: 97%

“…Retrospective studies have reported patient-initiated discontinuation rates of 6 to 26.8% for these adverse effects. [8][9][10][11][12][13] Patients excluded from analysis because of early discontinuation of medication may further overestimate the tolerability of netarsudil.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Topical ρ-Kinase Inhibitors in Veterans with Severe Glaucoma on Maximally Tolerated Medical Therapy

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In humans, the ROCK inhibitor netarsudil is approved for the treatment of refractory glaucoma. [ 68 ] In animal models, studies of RhoA pathway inhibition have most often utilized the bacterial endotoxin C3 transferase (a Rho GTPase inhibitor that targets RhoA as well as RhoB and RhoC) and ROCK inhibitors Y‐27632 and fasudil (HA‐1077). In addition to animal studies, fasudil has also been used in several clinical trials for a range of neurological diseases.…”

Section: Pathological Rhoa Activation In Neurological Diseasesmentioning

confidence: 99%

TRPV4: A trigger of pathological RhoA activation in neurological disease

2022

View full text Add to dashboard Cite

Transient receptor potential vanilloid 4 (TRPV4), a member of the TRP superfamily, is a broadly expressed, cell surface-localized cation channel that is activated by a variety of environmental stimuli. Importantly, TRPV4 has been increasingly implicated in the regulation of cellular morphology. Here we propose that TRPV4 and the cytoskeletal remodeling small GTPase RhoA together constitute an environmentally sensitive signaling complex that contributes to pathological cell cytoskeletal alterations during neurological injury and disease. Supporting this hypothesis is our recent work demonstrating direct physical and bidirectional functional interactions of TRPV4 with RhoA, which can lead to activation of RhoA and reorganization of the actin cytoskeleton.Furthermore, a confluence of evidence implicates TRPV4 and/or RhoA in pathological responses triggered by a range of acute neurological insults ranging from stroke to traumatic injury. While initiated by a variety of insults, TRPV4-RhoA signaling may represent a common pathway that disrupts axonal regeneration and blood-brain barrier integrity. These insights also suggest that TRPV4 inhibition may represent a safe, feasible, and precise therapeutic strategy for limiting pathological TRPV4-RhoA activation in a range of neurological diseases.

show abstract

“…A literature search conducted in PubMed revealed four studies investigating the effectiveness of netarsudil in patients already taking multiple IOP-lowering agents in real-world settings. 17 , 18 , 19 , 20 However, previous studies lack a control cohort that would be beneficial in comparing changes across time, avoiding potential biases, and clarifying the role of netarsudil in comparison to its peer medications. Among the different classes of medications that may be considered after prostaglandins, α-agonists are also poorly tolerated agents that are commonly prescribed.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Netarsudil versus Brimonidine in Eyes already Being Treated with Glaucoma Medications at a Single Academic Tertiary Care Practice: A Comparative Study

Pham

Bradley

Casey

et al. 2023

Current Therapeutic Research

View full text Add to dashboard Cite

Effectiveness of Netarsudil as an Additional Therapy for Glaucoma in Patients Already on Maximally Tolerated Medical Therapy

Cited by 11 publications

References 12 publications

Effectiveness of Topical ρ-Kinase Inhibitors in Veterans with Severe Glaucoma on Maximally Tolerated Medical Therapy

Effectiveness of Topical ρ-Kinase Inhibitors in Veterans with Severe Glaucoma on Maximally Tolerated Medical Therapy

TRPV4: A trigger of pathological RhoA activation in neurological disease

Effectiveness of Netarsudil versus Brimonidine in Eyes already Being Treated with Glaucoma Medications at a Single Academic Tertiary Care Practice: A Comparative Study

Contact Info

Product

Resources

About