It is safe to say that the glaucoma medication market is thriving with therapies that can help the vast majority of patients achieve their target IOPs.
The good news is that the products that comprise all of the various glaucoma drug classes are so highly efficacious as solo or combination therapies prescribed alone or in conjunction with additional drugs, that the need for glaucoma surgeries has decreased.
Two new recently introduced anti-glaucoma drugs are adding to this success as a result of a new mechanism of action, high efficacy, a low treatment burden.
New kids on the block
Aerie Pharmaceuticals has developed two new drugs that have become commercially available recently. One is netarsudil ophthalmic solution 0.02% (Rhopressa), a rho kinase inhibitor, and the second is netarsudil and latanoprost ophthalmic solution 0.02%/0.005% [Xalatan ophthalmic solution 0.005%] (Rocklatan), a combination of a prostaglandin and a rho kinase inhibitor, according to Fiaz Zaman, MD, who is on the clinical faculty, University of Houston, and in private practice at Houston Eye Associates, Houston.
The FDA approval of Rhopressa in 2018 marked the first member of a new class of anti-glaucoma drugs to appear since 1996 when latanoprost ophthalmic solution 0.005% (Xalatan, latanoprost Pfizer), a prostaglandin, entered the marketplace.
The beauty of this new drug class of rho kinase inhibitors is its unique mechanism of action to treat glaucoma, according to Dr. Zaman.
Previous classes of glaucoma drugs work to lower IOP by impacting the aqueous humor outflow or production; in contrast, rho kinase inhibitors work directly in the angle of the eye on the trabecular meshwork, with 70% to 80% of aqueous drainage occurring there, and the rest in the alternative pathway, the uveo-scleral pathway.
“Rhopressa targets the part of the eye that does most of the heavy lifting regarding aqueous drainage,” he said.
Fiaz Zaman, MD
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Dr. Zaman is a speaker for Aerie Pharmaceuticals and Allergan.