The effectiveness and safety profile of netarsudil 0.02% in glaucoma treatment: real-world 6-month outcomes

• DOI: 10.1007/s00417-021-05410-x
• Publication Date: 2021-09-22T05:02:30Z
• Authors: Eric J. Shiuey; Nikki A. Mehran; Melih Ustaoglu; Qiang Zhang; Reza Razeghinejad; Aakriti G. Shukla; Natasha N. Kolomeyer; Jonathan S. Myers; Daniel Lee
• Keywords: Aged, 80 and over; Glaucoma; Middle Aged; Benzoates; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; beta-Alanine; Humans; Ocular Hypertension; Ophthalmic Solutions; Glaucoma, Open-Angle; Intraocular Pressure; Aged; Retrospective Studies

To evaluate the efficacy and safety profile of netarsudil 0.02% ophthalmic solution in a tertiary glaucoma referral center.This retrospective cohort study included patients with glaucoma initiated on netarsudil 0.02% at a single institution from November 2017 to September 2018. Demographic and clinical data were collected, including intraocular pressure (IOP) and drug side effects at baseline and 1-, 3-, and 6-month follow-up visits.A total of 340 eyes of 233 patients were included; mean ± SD patient age was 69.1 ± 12.5 years. One hundred twenty (48%) eyes experienced ≥ 20% decreases in IOP at the 1-month study visit; this effect was maintained through the 6-month visit. IOP-lowering effects in patients using ≥ 3 topical glaucoma medications were similar (all p > 0.1). Eighteen (7.4%) and 7 (2.9%) patients experienced increases in IOP of ≥ 3 and ≥ 5 mmHg, respectively. Across all study visits, conjunctival hyperemia was noted at a rate of 27.6%, and though frequently reported, complaints of blurred vision (31.1%) did not manifest in significant worsening of visual acuity. The rate of drug discontinuation due to insufficient IOP-lowering and side effects was 15.6% and 24.8%, respectively. Twenty-nine (11.4%) and 82 (32.3%) eyes required additional medical and surgical/laser intervention, respectively.Commonly used as the last-line medical therapy in this case series, netarsudil safely and significantly reduced IOP in patients with glaucoma, even in those using ≥ 3 glaucoma medications. Increases in IOP of ≥ 3 mmHg occurred in a small number of patients. Subjective vision changes and conjunctival hyperemia were the most frequently reported side effects.