New glaucoma medications: latanoprostene bunod, netarsudil, and fixed combination netarsudil-latanoprost

Abstract

Reduction of intraocular pressure is the only proven method to treat glaucoma. Initial treatment of glaucoma commonly involves using anti-glaucoma medications either as monotherapy or combination therapy. Studies on aqueous humour dynamics have contributed to our understanding of aqueous outflow mechanisms that have led to the discovery of new drugs. Three new drugs (latanoprostene bunod 0.24%, netarsudil 0.02%, and fixed combination netarsudil 0.02% -latanoprost 0.005%) have been introduced recently in the market with novel mechanisms of action. Latanoprostene bunod 0.024% is a nitric oxide-donating prostaglandin F2α analogue which increases the aqueous outflow both by uveoscleral and trabecular pathways. Netarsudil 0.02% is a potent Rho kinase/norepinephrine transporter inhibitor acting by increasing the trabecular outflow, decreasing the aqueous production, and possibly decreasing the episcleral venous pressure. This review highlights the role of these drugs in the management of glaucoma, with an overview of the major clinical trials on their efficacy, safety, and tolerability.

摘要

研究证明, 降低眼压是治疗青光眼的唯一有效方法。青光眼的初步治疗通常使用单药或联合抗青光眼药物。房水动力学研究有助于我们对房水流出机制的认识和理解, 从而推动了新型药物的研发。近年来, 三种新型药物 (Vyzulta滴眼液0.24%、netarsudil滴眼液0.02%、固定比例的复合滴眼液: Vyzulta 0.02%- netarsudil 0.005%) 均具有独特的作用机制于近期已经投入市场。Vyzulta滴眼液0.024%为释放一氧化氮的前列腺素F2α模拟物,可同时增加葡萄膜、巩膜以及小梁网途径的房水排出。netarsudil滴眼液0.02%是一种有效的Rho激酶/去甲肾上腺素转运抑制剂, 能增加小梁网途径房水的流出, 减少房水产生, 以及可能降低外周静脉压力。本文强调了对这些药物在青光眼治疗中的作用, 同时总结了对其进行疗效、安全性和耐受性主要的临床试验结果

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Correspondence to Reza Razeghinejad.

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Mehran, N.A., Sinha, S. & Razeghinejad, R. New glaucoma medications: latanoprostene bunod, netarsudil, and fixed combination netarsudil-latanoprost. Eye 34, 72–88 (2020). https://doi.org/10.1038/s41433-019-0671-0

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