Early response to Durysta may lead to long-term IOP reduction

ByRobert Linnehan

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Patients with glaucoma who displayed an early treatment response to a 10 µg bimatoprost implant and experienced greater than 20% IOP lowering at 12 weeks had significantly greater odds of a long-term IOP response, according to a speaker.

“Those patients that are greater than 20% reduction of their eye pressure actually ended up having a much greater likelihood of having a long-term response,” Jacob W. Brubaker, MD, said at the virtual American Glaucoma Society annual meeting.

Patients with open-angle glaucoma were randomly assigned to receive 10 µg or 15 µg Durysta (bimatoprost implant, Allergan) in the ARTEMIS phase 3 studies. The researchers evaluated early IOP response in patients who received the 10 µg bimatoprost implant and its effect on long-term IOP reduction.

Patients in the studies received bimatoprost implants administered intracamerally on day 1, week 16 and week 32 or topical timolol 0.5% twice daily. Researchers evaluated IOP in a subgroup of patients who remained in the study through month 20 without receiving rescue treatment in their study eye compared with all other patients.

Three hundred seventy-four patients received the 10 µg implant, and 240 remained through month 20 without rescue treatment. These patients demonstrated excellent IOP control through the first 12 weeks after the first administration, Brubaker said.

Through the first 12 weeks, the long-term responders had a mean IOP of 16.5 mm Hg compared with a mean IOP of 18.1 mm Hg in patients who were rescued or exited early (P < .001). Long-term responders also had a significantly lower baseline mean IOP of 24.1 mm Hg compared with a mean IOP of 25.2 mm Hg in all other patients (P < .001).

Also, the odds for long-term IOP response were better in patients with greater than 20% IOP lowering from baseline to week 12 compared with patients who experienced 20% or less IOP lowering from baseline.

“The odds ratio was about 1.85 that they would do better. If we’re looking at our patients as we first dose them, we can see if they have a very good response. That gives us the confidence as we’re treating them that they’ll actually maybe be some of these long-term responders and not need as many doses over time,” Brubaker said.

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Source:

Brubaker JW, et al. Long-term IOP lowering after 3 administrations of bimatoprost implant in the ARTEMIS phase 3 studies: Relationship to early IOP response. Presented at: American Glaucoma Society annual meeting; March 4-7, 2021 (virtual meeting).

Disclosures: Brubaker reports he is a consultant for and has received research support from Allergan.