Prostaglandin-associated periorbitopathy syndrome (PAPS): Addressing an unmet clinical need

ABSTRACT

Background: Topical prostaglandin analogs (PGAs) are widely approved and preferred first-line options for glaucoma and elevated intraocular pressure (IOP). However, prostaglandin-associated periorbitopathy syndrome (PAPS) is now a well-recognized clinical and cosmetic concern for patients receiving PGAs, especially during long-term and unilateral therapy. PGA-associated periocular changes occur in a substantial proportion of patients, with older patients (>60 years) at greater risk of clinical presentation. PAPS may hinder long-term management of glaucoma, including treatment adherence, ophthalmic surgery outcomes, and reliable IOP measurements. Recommendation: New therapeutic approaches may address this unmet clinical need. Omidenepag isopropyl (OMDI) is a novel, non-prostaglandin, selective EP₂ receptor agonist in ongoing development, which provides a unique pharmacological mechanism of action. OMDI appears to provide IOP reductions comparable to PGAs, but without PAPS-related undesirable effects. OMDI may offer a suitable long-term option for patients who demonstrate decreased efficacy, or failure, of PGAs, plus patients with significant PAPS, while fulfilling international guidelines.

KEYWORDS:

• PGA
• periorbitopathy
• PAPS
• Omidenepag isopropyl
• glaucoma

Acknowledgments

Medical writing support was provided by Synergy Vision.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The authors of this review article were sponsored by Santen Pharmaceutical Asia Pte. Ltd. alongside the decision to submit the article for publication. The research, preparation and writing of the article were independent of the sponsor.