Glaucoma clinical research: Trends in treatment strategies and drug discovery

Abstract

AbstractPurposeTo investigate trends and progresses in glaucoma research.MethodsAll clinical trials with glaucoma covered by Clinicaltrials.gov and Australianclinicaltrials.gov initiated before 1 January 2021 were included. Trials evaluating glaucoma treatment were separated from non‐treatment trials and divided into three major categories: laser‐, surgical‐ and medical treatment. New medical treatment compounds and targets were identified and subcategorized according to treatment strategy; intraocular pressure (IOP)‐lowering, neuroprotective or vascular. The phase transition success rates were calculated.Results1537 trials were identified. 63% (n = 971) evaluated glaucoma treatment, of which medical treatment accounted for the largest proportion (53%). Most of the medical trials evaluated IOP‐lowering compounds, while trials evaluating neuroprotective or vascular compounds accounted for only 5% and 3%, respectively. 88 unique new compounds were identified. Phase I, II and III transition success rates were 63%, 26% and 47%, respectively.ConclusionsClinical trials in glaucoma have increased significantly over the last 30 years. All three main treatment strategies were represented among the recently evaluated compounds, but clinical trials in neuroprotection and vascular modalities are still sparse. In addition to traditional medicines, dietary supplements and growth factors are also evaluated for a potential anti‐glaucomatous effect. Phase II and III success rates were below previously reported success rate for all diseases and ophthalmology in general. A stricter phenotyping of patients can improve the success rates in glaucoma and ophthalmology research and gain a better understanding of treatment responders and non‐responders.