BLOG: Unexpected present, positive results
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During a most unexpected and challenging year, ophthalmic practices are looking for reasons to celebrate.
The FDA approval of Allergan’s Durysta (bimatoprost implant), an intracameral implant for ocular hypertension and open-angle glaucoma, has been one positive development for practices and patients alike. This implant uses sustained drug delivery technology to gradually release bimatoprost directly into the eye over several months. I’ve previously written about how glaucoma specialists are changing their mindset from reactive to proactive, and Durysta is the latest innovation leading this shift.
Introducing Durysta to patients
As a practitioner, I’m always excited to try new therapies, and I’m even more excited when I see them changing the lives of my patients. Since Durysta became available this summer, I have administered the implant to 120 patients. When the implant was first approved in March, my primary concern was how patients would perceive the procedure. While intravitreal injections have been a staple in the treatment of various retinal conditions for some time, patients with glaucoma are mainly treated with eye drops. As such, I was concerned that patients would be hesitant to receive the implant. I like to preemptively address this concern, so my patients do not have time to become nervous or overcomplicate the procedure in their head. Usually I can allay any fears they may have simply by saying: “Mrs. Smith, I know the biggest concern is whether it will be painful. It won’t be. You won’t feel the administration because I will numb your eyes with drops.”
Happier patients
Most of my patients are surprised after Durysta is implanted because they do not realize that I completed the administration. Some have even asked if I could administer the second eye on the same day. While I will not administer Durysta to two eyes in one visit, I am pleased by the overwhelmingly positive response I have received from my patients. It might not come as a surprise that patients are happy when I take them off their daily prostaglandin analog and secondary medications. As glaucoma specialists, we’ve always had a hard time improving quality of life, unlike cataract specialists whose patients can notice an immediate improvement in their vision after surgery. Durysta has made it possible to offer our patients a meaningful improvement in quality of life starting on the day we administer the implant.
Healthier eyes
My Durysta patients are not only happier, but importantly they are also healthier. I am seeing IOP come down in my patients who have received the implant. In the pivotal phase 3 ARTEMIS studies, Durysta demonstrated a mean IOP reduction of approximately 5 mm Hg to 8 mm Hg at 15 weeks in patients with a mean baseline IOP of 24.5 mm Hg, about a 33% reduction. The declines in IOP I have observed are supported by the data, but in some patients the reduction in IOP has been better than expected.
Lowering IOP is the only treatable risk factor for glaucoma, and for many years, the standard treatment has been eye drops. I suspect my patients who are seeing some of the largest decreases in IOP may not have been taking their drops as prescribed and are now for the first time receiving therapeutic doses of medication to their diseased eye tissues.
Conclusion
Durysta is a new sustained-release drug delivery system that I can offer to my pseudophakic patients who are on a prostaglandin. The momentum for uptake of Durysta in my practice continues to grow as more patients receive the implant. The results to date have been meaningful for my patients, and I believe Durysta represents another paradigm shift in the treatment of glaucoma.
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