Rho-Kinase-Hemmer als neue lokale Therapieoption beim primären Offenwinkelglaukom

Erb, Carl; Konieczka, Katarzyna

doi:10.1007/s00347-020-01303-2

Cited by 5 publications

(6 citation statements)

References 107 publications

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“…These included conjunctival hyperemia, which was the most common, followed by subconjunctival hemorrhage and cornea verticillata. Nevertheless, they were minor and were consistent with those reported in other Rho kinase studies [ 15 , 17 ]. Conversely, systemic side effects were significantly more frequent in patients treated with timolol, notably bradycardia, and musculoskeletal and gastrointestinal disorders.…”

Section: Discussionsupporting

confidence: 92%

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Efficacy and Safety of Rho Kinase Inhibitors vs. Beta-Blockers in Primary Open-Angle Glaucoma: A Systematic Review with Meta-Analysis

Nana Wandji,

Bacq,

Ehongo

2024

JCM

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Background: In order to support the positioning of Rho kinase inhibitors (Rhokis) in the European market for the treatment of glaucoma, scientific evidence comparing the efficacy and safety of Rhokis and beta-blockers (β-βs) in the treatment of open-angle glaucoma after 3 months was assembled through a systematic review and meta-analysis (meta-A) of randomized controlled trials (RCTs). Methods: Relevant articles were searched for on PubMed, EMBASE, and the Cochrane Library. Of the 251 articles found, three met all eligibility criteria. These three articles were assessed for risk of bias. Data were extracted and a random effects meta-A was performed. The studies’ methods were homogeneous but there was great heterogeneity within the data (I2 = 92–93%; p < 0.001). Results: All studies had low risk of bias. The meta-A showed statistically better efficacy of β-βs, resulting in an intraocular pressure (IOP) reduction mean difference of 1.73 (1.19–2.27) at 8 a.m., 0.66 (0.19–1.15) at 10 a.m. and 0.49 mmHg (0.001–0.98) at 4 p.m., compared to Rhokis. This difference is not clinically significant as intra-operator variability of IOP measurements varies from ±2 to ±3 mmHg The adverse effects of Rhokis were essentially topical, whereas β-βs mainly caused systemic side effects. Conclusions: This Meta-A showed that Rhokis are clinically non-inferior to beta-blockers in reducing IOP. Rhokis have a better safety profile.

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Section: Discussionsupporting

confidence: 92%

“…Moreover, Rho kinase inhibitors have mainly topical side effects, generally conjunctival hyperemia [ 15 ]. This new therapeutic class was approved in Japan in 2014 and in the USA in 2017 [ 16 ], but not in Europe, where studies have only been conducted, in Germany, since 2021 [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Rho Kinase Inhibitors vs. Beta-Blockers in Primary Open-Angle Glaucoma: A Systematic Review with Meta-Analysis

Nana Wandji,

Bacq,

Ehongo

2024

JCM

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“…Rho kinase activation negatively regulates NO production, suppressing NO-mediated vessel dilatation. It is assumed that NO-mediated dilatation triggered by statins appeared by the inhibition of the mevalonate–Rho pathway in retinal arterioles [ 56 ]. This hypothesis was supported by Nagaoka et al [ 57 ], showing data that the inhibition of the mevalonate–Rho kinase pathway in endothelial cells plays a part in the simvastatin-induced vasodilation in porcine retinal arterioles.…”

Section: Discussionmentioning

confidence: 99%

Erlanger Glaucoma Registry: Effect of a Long-Term Therapy with Statins and Acetyl Salicylic Acid on Glaucoma Conversion and Progression

Thiermeier

Laemmer

Mardin

et al. 2021

Biology

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Purpose: Drugs with cardiovascular protective properties (statins, acetylsalicylic acid (ASS)) were assumed to have positive effects on patients suffering from glaucoma disease. The present retrospective study aimed to investigate the influence of statins, ASS or a combination of both on the glaucoma conversion and progression rate in glaucoma suspects and glaucoma patients with a 20-year follow-up period. Methods: A retrospective analysis of 199 eyes of 120 patients (63 male, 57 female) of the Erlanger Glaucoma Registry (EGR; ClinicalTrials.gov Identifier: NCT00494923; ISSN 2191-5008, CS-2011) was performed considering systemic therapy with statins, ASS or a combination of both: 107 eyes with ocular hypertension (OHT) and 92 eyes with pre-perimetric primary open-angle glaucoma (pre-POAG). All patients received an ophthalmological examination including morphometric and functional glaucoma diagnostics. Glaucoma conversion was defined as the conversion of OHT to pre-POAG. Glaucoma progression was defined as confirmed visual field loss. Data were shown as percentages. Statistical analysis was performed by Chi-Quadrat tests. Results: 1. Glaucoma conversion/progression was observed in 46.7% of the subjects, additionally in combination with hypercholesterinemia in 76.8%. 2. Statins: 27.3% of eyes under systemic statin therapy showed a conversion/progression. Patients taking statins ≥ 10 years yielded a reduced conversion/progression rate (p = 0.028, non-significant after Bonferroni–Holm). 3. ASS: 34.7% of eyes under systemic ASS therapy showed a conversion/progression. A significantly lower conversion/progression rate was observed after ASS therapy ≥ 12 years (p = 0.017, significant after Bonferroni–Holm). 4. ASS and statins: 25.0% of eyes under combined therapy showed a conversion/progression. A significantly reduced conversion/progression rate was reached after 8 years of combined therapy (p = 0.049, non-significant after Bonferroni–Holm). Conclusions: Patients with ocular hypertension and early glaucoma seem to benefit from adjuvant cardiovascular protective therapy. However, the benefits and disadvantages of treatment with statins and/or ASS should be kept in mind. Thus, a thorough risk–benefit evaluation has to be performed for each patient individually to avoid unwanted side effects.

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“…ñò. çàôèêñèðîâàíî ó ïî÷òè âòðîå áîëüøåãî ÷èñëà ïàöèåíòîâ, ïîëó÷àâøèõ ðîêëàòàí, ïî ñðàâíåíèþ ñ ÷èñëîì ïàöèåíòîâ, ïîëó÷àâøèõ ëàòàíîïðîñò [36]. Íàèáîëåå ÷àñòûì ïîáî÷íûì ýôôåêòîì ïðè ïðèìåíåíèè ðîêëàòàíà áûëà ãèïåðåìèÿ êîíúþíêòèâûâ 65 %.…”

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Modern trends in the treatment of glaucoma

Petrov,

Yakubova,

Markelova

2024

Rossijskij oftalʹmologičeskij žurnal

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In nearly all Russian regions, glaucoma ranks first among the causes of disability due to ophthalmic pathology, which is in line with global trends of glaucoma incidence growth and its leading position among the causes of irreversible blindness. Treatment of glaucoma is aimed at lowering intraocular pressure (IOP). This review presents the main current trends in the treatment of glaucoma: drug therapy, laser surgery, fistulizing, drainage and non-penetrating surgery, as well as the latest micro-invasive glaucoma surgery (MIGS).Currently, the pharmaceutical market offers many antihypertensive drops. Fixed-dose combinations of drugs have been proposed to increase treatment adherence, and effective drug delivery methods are being developed, which lower IOP with minimal side effects. Further development of laser surgery makes it both a method of choice for the initial treatment (selective laser trabeculoplasty) and expands its capabilities for various stages of glaucoma (micropulse cyclophotocoagulation). All this significantly reduces the frequency of classical macroinvasive antiglaucoma operations. The previously existing gap between conservative medical therapy and antiglaucoma surgery is filled by the newest MIHG procedures. In recent years, at all stages of primary open-angle glaucoma therapy, the emergence of new pharmaceuticals, methods and implants has been noted. These constitute the purpose of this publication.

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Rho-Kinase-Hemmer als neue lokale Therapieoption beim primären Offenwinkelglaukom

Cited by 5 publications

References 107 publications

Efficacy and Safety of Rho Kinase Inhibitors vs. Beta-Blockers in Primary Open-Angle Glaucoma: A Systematic Review with Meta-Analysis

Efficacy and Safety of Rho Kinase Inhibitors vs. Beta-Blockers in Primary Open-Angle Glaucoma: A Systematic Review with Meta-Analysis

Erlanger Glaucoma Registry: Effect of a Long-Term Therapy with Statins and Acetyl Salicylic Acid on Glaucoma Conversion and Progression

Modern trends in the treatment of glaucoma

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