Investigational and experimental drugs for intraocular pressure reduction in ocular hypertension and glaucoma

ABSTRACT

Introduction: Intraocular pressure (IOP) is the most significant modifiable risk factor to prevent onset or progression of glaucoma. Glaucoma prevalence continues to increase, emphasizing the need for improved ocular hypotensive treatment options. To try to improve on both tolerance and IOP control of currently available therapies, different receptors or mechanisms are being explored to reduce IOP more effectively and to improve tolerance.

Areas covered: We review synthetic topical and oral drugs in early development for the management of ocular hypertension and glaucoma.

Expert opinion: New therapeutic agents for IOP control have been discovered; some appear to be reasonably tolerated. IOP reduction may be limited with some agents, but other benefits although unproven may compensate for this, such as less ocular surface disease, enhanced neuro-protection or increased ocular blood flow. Further product development promises improved treatment options for ocular hypertensives and glaucoma sufferers.

KEYWORDS:

• Ocular hypertension
• glaucoma
• open angle glaucoma
• compliance

Article highlights

• The goal of glaucoma treatment is sustained and effective IOP lowering with minimal side effects.

• Commercial ocular hypotensive treatments are limited by side effects and poor compliance.

• New therapeutic targets are being investigated and provide alternative mechanisms for IOP control, along with favorable safety profiles.

• Oral drug delivery is being explored, which will expand medical treatment options for glaucoma.

• A number of new ocular hypotensive agents have dual mechanisms such as neuro-protection or improved ocular surface disease.

This box summarizes key points contained in the article.

Declaration of interest

I. Goldberg has been a consultant and on advisory boards for Alcon Laboratories, Allergan, Forsight, and Pfizer. He has received research support from Alcon Laboratories and Allergan and travel support from Pfizer. The authors have no other 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 apart from those disclosed.

Additional information

Funding

This paper is not funded.