Outcomes and impressions of netarsudil/latanoprost fixed-dose combination therapy after switching from latanoprost monotherapy

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Evaluation of the fixed-dose combination of netarsudil 0.02%/latanoprost 0.005% (Rocklatan, Alcon) instilled once daily in patients with glaucoma showed that the patients achieved the targeted IOP levels and would be willing to continue treatment with the formulation. Valerie Trubnik, MD, FACS, from Ophthalmic Consultants of Long Island, Mineola, NY, reported the results at the American Society of Cataract and Refractive Surgery annual meeting in Boston.¹

She and her coauthors explained that the fixed-dose combination drug lowers IOP but concerns about hyperemia have been expressed, which may have caused physicians to not recommend or adopt the drug. The investigators conducted a multicenter, prospective, open-label, phase 4 study in which they evaluated the patients’ and investigators’ impressions of the drug. The factors evaluated were its tolerability, convenience of dosing, and willingness to continue after switching from a baseline latanoprost regimen to the fixed-dose combination.

The patients, all of whom had either open-angle glaucoma or ocular hypertension, instilled the fixed-dose combination therapy every night for 12 weeks. They were evaluated at 3 time points in the mornings on day 0 and weeks 6 and 12 to measure the IOP and drug safety, the investigators explained. The inclusion criteria included that they had been taking latanoprost monotherapy for 30 days or longer and that the IOP measured in the morning was 20 mmHg or higher.

The patients and physicians completed a questionnaire to record their impressions at the last evaluation.

Results of switching to the fixed-dose combination

A total of 110 patients were included in the study. At the end of the study, the vast majority of patients, ie, 92.7%, “reported comfort with the medication, and 78.2% experienced a similar or better level of comfort as [with] previous medications,” the investigators reported.

Almost all patients, 95.5%, reported that they tolerated the medication either well, mostly well, or very well.

About three-quarters of patients reported eye redness associated with the drug. About two-thirds indicated that the hyperemia was tolerable if the drug controlled the IOP.

The authors commented, “Overall, 89.1% of participants reported a good or better satisfaction level, and 83.6% would consider continuing with the therapy; 76.4% of participants achieved the target IOP and 77.3% indicated that they would continue on the fixed-dose combination therapy.”

The investigators concluded that most subjects had a favorable response to the fixed-dose combination therapy and were willing to continue with it; the investigators reported that most achieved the target IOP and that they would continue the patients on the fixed-dose combination therapy.

1. Conference Abstract or Poster
   Trubnik V, Bacharach J, Merchea M, Yeh TN.Patient-reported outcomes and investigator impressions after switching to netarsudil/latanoprost fixed-dose combination therapy. Paper presented at: American Society of Cataract and Refractive Surgery 2024 annual meeting; April 5-8, 2024; Boston, Massachusetts, USA. Session: SPS-107 Glaucoma Procedures and Medications.