The idea that a neuroprotective agent for glaucoma will be available within the next decade is wishful thinking, but not unrealistic, according to Robert N. Weinreb, MD.
Dr. Weinreb said that with selection of an appropriate drug and implementation of new testing paradigms, there is a high likelihood that a trial of a neuroprotective agent could achieve its clinical endpoints within a reasonable time period and at a reasonable cost.
“I am optimistic that within five to 10 years, we will have a neuroprotective agent that would slow the rate of glaucoma damage,” said Dr. Weinreb, distinguished professor and chairman, Department of Ophthalmology, and director of the Shiley Eye Institute, University of California, San Diego.
Outlining the pathway to developing a commercially available neuroprotective agent, Dr. Weinreb explained that an “appropriate drug” could be one that has been shown to have neuroprotective activity in an experimental model and that has demonstrated safety and perhaps some efficacy in a pilot clinical study.
Study population defined
The study population would have to be tightly defined, which would allow for a trial with adequate power to detect what may be a moderate treatment effect with a smaller sample size. Dr. Weinreb suggested proper candidates would be patients whose glaucoma is rapidly progressing on standard therapy or who have significant risk factors for progression, such as exfoliation, disc hemorrhage, or family history of glaucoma.