Efficacy and safety of netarsudil 0.02% ophthalmic solution in patients with open-angle glaucoma and ocular hypertension

Abstract

ABSTRACTIntroduction: Currently, the only modifiable risk factor to slow or halt the progression of glaucoma is the lowering of intraocular pressure (IOP). Netarsudil 0.02% is a new medication that was approved by the U.S. FDA in 2017 for reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.Areas covered: We reviewed recent literature on the efficacy and safety of netarsudil both alone and in combination. We included recently published manuscripts from both human and animal studies.Expert opinion: Netarsudil functions by inhibiting rho-associated protein kinases, making it the first IOP lowering medication to directly target the trabecular meshwork. Although the efficacy of the medication in lowering intraocular pressure has been substantiated in numerous studies, the ocular hypotensive effect of netarsudil is in the range of timolol, and less than latanoprost in most studies. The safety profile of netarsudil differs from other currently approved topical ocular hypotensive agents, and at least half of the patients using it are expected to have adverse events – although they may be mild and transient. A fixed-dose combination of netarsudil with latanoprost was approved in March 2019, which has greater ocular hypotensive efficacy than either netarsudil or latanoprost alone.