Fixed combination netarsudil-latanoprost for the treatment of glaucoma and ocular hypertension

ABSTRACT

Introduction: Reduction of intraocular pressure (IOP) is the only known modifiable risk factor for prevention and treatment of glaucoma. Rho-kinase (ROCK) inhibitors are a new class of glaucoma medications introduced recently with novel mechanisms of action and favorable safety profiles. Latanoprost, a common first line drug used for treatment of glaucoma, does not adequately control pressures in all cases. Addition of more than one anti-glaucoma medication affects patient compliance and adherence. Fixed-combination eye drops are combinations of two or more active drugs in a single dosage form, thus simplify dosing. New to this group is the fixed combination netarsudil- latanoprost (FCNL).

Area covered: This review focuses on FCNL, its pharmacodynamics and pharmacokinetics. It also details the efficacy and safety of individual drugs compared to FCNL.

Expert opinion: The combination of latanoprost and netarsudil is a potent medication and modulates all known targets for IOP reduction in a single drop and has been shown to be more effective than either drug alone. FCNL is an alternative for those with inadequately controlled IOP on a prostaglandin analog alone, as well as those for whom a simplified regimen is desirable, or those who are not good candidates for other classes of glaucoma medications.

KEYWORDS:

• Adherence
• fixed-combination netarsudil (AR-1324)-latanoprost
• glaucoma
• latanoprost
• ocular hypertension
• prostaglandin analogues
• tolerability

Article Highlights

• FCNL is the first medicine combining a rho-kinase inhibition with a prostaglandin analog.

• It is the only fixed combination agent that improves aqueous outflow via conventional and uveoscleral route.

• The most frequently reported ocular side effect is conjunctival hyperemia.

• FCNL is more effective than either netarsudil or latanoprost alone in lowering the IOP.

• Once daily instillation of FCNL modulates all known targets for IOP reduction in a single drop thus improving drug compliance and adherance.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

One referee is a consultant for Santen and is also involved with the Aerie MERCURY 4 investigation which is currently ongoing. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This manuscript was not funded.