What’s new in glaucoma device, drug therapy advances

San Francisco-Given that a glaucoma treatment is now a $5 billion market, an ophthalmic company starts talking to venture capital firms when it needs that first $1 million to move a product from clinical trials to realized treatment, said Emmett Cunningham, MD, PhD, MPH, partner at Clarus Ventures. He gave a brief overview of recent new product advances during the 3rd Annual Glaucoma 360 New Horizons Forum.

Dr. Cunningham reported Rho-associated protein kinase (ROCK) inhibitors have phase II clinical trials data available that demonstrate efficacy. ROCK inhibitors target cells in the trabecular meshwork to encourage aqueous humor outflow, which can limit redness and may be better than prostaglandin analogues in reducing IOP. He cited Aerie Pharmaceutical’s product AR-13324 phase II study outcome of reducing IOP by 5 mm Hg in a patient subgroup. AR-13324 is now undergoing phase III study.  

In the $46 million device market, micro-invasive glaucoma surgery is progressing through patient trials and is projected to reach the general practice market by 2016. One device (CyPass Micro-Stent, Transcend Medical) has been tested in Europe since 2009 and is currently available in the United States through the COMPASS clinical study. The micro-stent drains intraocular fluid, thereby reducing IOP.

Drug delivery glaucoma treatments show less than a 50% use at 6 months after starting therapy. New products, now in several phase II trials, offer sustained release of glaucoma medications that may improve continuous patient use. For instance, Ocular Therapeutix just received 14 million in a Series D round of venture capital to develop its hydrogel treatments. 

Device diagnostics, such as smart contact lenses (for instance, Sensimed Triggerfish), continue to undergo testing. The Triggerfish electronic contact lenses are capable of continuous measurement of IOP.  

Functional outcomes of all these products for patients with glaucoma will be required for payers to cover them under current health-care insurance initiatives, Dr. Cunningham concluded.  

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