Indian Journal of Ophthalmology (Jan 2023)

Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety

  • Manoj Chandra Mathur,
  • P Venkat Ratnam,
  • S J Saikumar,
  • Manuel John,
  • Siddharth Ravishankar,
  • M B Dinesh,
  • Priya Chandil,
  • Kishore Pahuja,
  • Vidya Cherlikar,
  • Sunny Wadhwani,
  • Pankaj Bendale,
  • Ajit Hazari,
  • Rajesh Mishra,
  • Susheel Deshmukh,
  • Rahul Raja Achlerkar,
  • Devang Tilak Shah,
  • Chanda Hingorani,
  • Kaivan Shah,
  • Pratik Topiwala,
  • Sheetal Jani,
  • Viral G Rana,
  • Nilay Kumar Majumdar,
  • Debasis Chakrabarti,
  • Rituparna Dey,
  • Debabrata Halder,
  • Sumit Choudhury,
  • Ajeet Kumar,
  • Sasmita Das,
  • Ashok Kumar Nanda,
  • Vidya Bhushan Kumar,
  • Rama Dubey,
  • Gulam Ali Kamdar,
  • Alka Pandey,
  • Sheetal Kishanpuria,
  • Rajat Mohan Srivastava,
  • Parul Singh,
  • Sunil Kumar Verma,
  • Neha Sharma,
  • Rajeev Gupta

DOI
https://doi.org/10.4103/IJO.IJO_25_23
Journal volume & issue
Vol. 71, no. 6
pp. 2500 – 2503

Abstract

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Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40-80. The best way to manage primary open-angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open-label, real-world, multicentric, observation-based 3-month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first-line therapy. Diurnal IOP measurements, best-corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day-1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty-nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once-daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first-line treatment in primary open-angle glaucoma and ocular hypertension was both safe and effective.

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