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Trabodenoson significantly reduced IOP in ocular hypertension, POAG
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Researchers found that twice-daily ocular doses of trabodenoson were well tolerated and decreased IOP in patients with ocular hypertension or primary open-angle glaucoma.
In the multicenter, randomized, double-masked, placebo-controlled, dose-escalation phase 2 study, patients received topical twice-daily trabodenoson (50 mcg, 100 mcg or 200 mcg) or placebo for 14 days or 500 mcg trabodenoson or placebo for 28 days.
Mean IOP reductions from diurnal baseline ranged from 3.5 mm Hg 5.0 mm Hg with a mean reduction of 4.1 mm Hg in the 500 mcg group and 1.0 mm Hg to 2.5 mm Hg with a mean reduction of 1.6 mm Hg for the placebo group, according to researchers.
The day 28 drop in IOP was significantly greater than at day 14, showing improvement in IOP lowering with longer treatment time, according to researchers.
Trabodenoson is a first-in-class selective adenosine mimetic designed to lower IOP at the trabecular meshwork and is currently in phase 3 development, according a press release from Inotek Pharmaceuticals.
“Patients with glaucoma have limited therapeutic options that provide reduction in IOP with good tolerability,” David P. Southwell, president and CEO of Inotek, said in the press release. “The data from the phase 2 trial demonstrated the potential of trabodenoson to provide clinically meaningful reductions in IOP with a favorable safety profile.”
Perspective
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Scott Anthony, OD, FAAO
Although the current regimen of glaucoma medications enables over 50% reduction in intraocular pressure in some patients, it generally requires utilizing multiple drug classes.
Prostaglandin analogs, carbonic anhydrase inhibitors, beta-blockers and alpha-adrenergic agonists used in combination will often allow us to reach the targeted therapeutic IOP.
However, patients must endure daily instillation of multiple eye drops, some of which result in ocular surface agitation or, worse, systemic side effects. For those glaucoma patients who require a multiple drop cocktail to stabilize the disease, the ability to limit the treatment burden to one or two powerful ocular hypotensive agents would be revolutionary.
Prostaglandins have proven to be very effective, but clinicians are ready for a new glaucoma medication with even better outcomes. At the very least, trabodenoson may offer clinicians a new drug class for treating glaucoma. If it can equal or surpass the IOP-lowering effects of prostaglandins, that would be a true game-changer, but we will have to wait for the completion of the phase 3 clinical trials to see if this is the one.
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