Rho kinase inhibitor added to glaucoma treatment options

HONOLULU — Once daily netarsudil is an “excellent addition” to glaucoma treatments, Janet B. Serle, MD, said at the Association for Research in Vision and Ophthalmology meeting here. The treatment is now available in the U.S.

The rho kinase inhibitor netarsudil 0.02% (Rhopressa, Aerie Pharmaceuticals) lowers IOP and is well tolerated, she told Healio.com/OSN, explaining a poster presentation of the ROCKET 2 study.

The once daily administration addresses compliance and the novel mechanism acts by enhancing outflow at the tissue that is altered in glaucoma — the trabecular meshwork. Secondarily, rho kinase inhibitors reduce episcleral venous pressure, she said.

ROCKET 2 evaluated the safety and efficacy of Rhopressa compared with timolol 0.05% in patients with open angle glaucoma and ocular hypertension in a 12-month, double-masked, randomized, multicenter, parallel group study.

A total of 436 patients completed month 12 of the study: 146 on once-daily dosing of the study drug at night, 86 on twice daily dosing, and 204 on twice daily dosing of timolol.

Main ocular side effects of Rhopressa at 12 months were the same as were shown at 3 months and included conjunctival hyperemia, cornea verticillata and small conjunctival hemorrhages. Conjunctival hyperemia was typically mild, cornea verticillata did not appear to affect visual acuity or function, and conjunctival hemorrhages were small and transient, she said.

“I anticipate [Rhopressa] should be additive to other drugs that lower IOP in all the other classes,” Serle said. – by Patricia Nale, ELS

Reference: Serle JB. Long-term safety and ocular hypotensive efficacy of netarsudil ophthalmic solution: the ROCKET-2 study. Presented at: Association for Research in Vision and Ophthalmology annual meeting; April 28-May 3, 2018; Honolulu.

Disclosure: Serle reports she is a consult for Aerie Pharmaceuticals.