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Glaucoma drugs may be repurposed with sustained-release implants

Issue: June 2016

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PRAGUE — Sustained-release implants may offer the opportunity to repurpose glaucoma drugs, overcoming noncompliance issues, according to one specialist speaking at the European Glaucoma Society Congress.

James David Brandt, MD, said that intraocular implants are effective and have the advantage of avoiding allergic reactions on the ocular surface. However, there is a small risk of infection related to the injection, and the procedure is not easily reversible. If the patient develops an adverse reaction such as macular edema, surgery is needed to remove the implant.

James David Brandt

Numerous companies are involved in early-phase development of intraocular drug delivery of prostaglandins, and the closest to marketing is Bimatoprost SR (Allergan). The device is currently being evaluated in a U.S. phase 3 study recruiting more than 600 patients at multiple sites, and other European regulatory studies are underway.

Among extraocular implants, punctum plug drug delivery implants are safe and easy to insert but contain limited amounts of drug and may cause epiphora in some patients.

“The worst is that the implant may fall out without the patient being aware,” Brandt said.

The bimatoprost ocular insert (ForSight VISION5) is a simple silicone ring that rests under the eyelids. It is replaced by the physician every 6 months. Results were recently published in Ophthalmology in which sustained lowering of IOP over 6 months was demonstrated. In an open-label extension of the study, efficacy was observed over 13 months, and 19-month data will be presented at the American Academy of Ophthalmology meeting.

“These are the longest sustained-release device data and look very promising,” Brandt said. – by Michela Cimberle

Reference:

Brandt JD. Drug delivery: new systems for old drugs. Presented at: European Glaucoma Society Congress; June 19-22, 2016; Prague.

Brandt JD, et al. Ophthalmology. 2016;doi:10.1016/j.ophtha.2016.04.026.

Disclosure: Brandt reports he is a consultant to Glaukos and ForSight VISION5.