Intraocular pressure-lowering efficacy and ocular safety of Rho-kinase inhibitor in glaucoma: a meta-analysis and systematic review of prospective randomized trials

• Published in: Graefe's archive for clinical and experimental ophthalmology 2022-03, Vol.260 (3), p.937-948
• Main Authors: Wu, Jo-Hsuan, Chang, Sheng-Nan, Nishida, Takashi, Kuo, Bo-I, Lin, Jou-Wei
• Format: Article
• Language: English
• Subjects: Antihypertensive Agents - therapeutic use; Archives & records; Cornea; Double-Blind Method; Enzyme inhibitors; Glaucoma; Glaucoma - chemically induced; Glaucoma - drug therapy; Glaucoma, Open-Angle - drug therapy; Hemorrhage; Humans; Hyperemia; Hypertension; Intraocular Pressure; Medicine; Medicine & Public Health; Meta-analysis; Ocular Hypertension - chemically induced; Ocular Hypertension - drug therapy; Ophthalmic Solutions; Ophthalmology; Placebos; Randomized Controlled Trials as Topic; Rho-associated kinase; rho-Associated Kinases; Systematic review; Timolol; Timolol - therapeutic use; Treatment Outcome
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-021-05379-7

Purpose To evaluate the intraocular pressure (IOP)-reducing efficacy and safety of Rho-kinase inhibitor (RKI). Methods Published studies in PubMed and EMBASE were searched on March 20, 2021. Study selection and data extraction were performed according to PRISMA. Meta-analysis of the IOP-lowering effect was performed with the bivariate random-effects model, with studies categorized into 2 classes: RKI versus placebo and RKI versus another medication. The main outcome was the difference in IOP reduction between RKI and non-RKI groups. Subgroup analysis of adjunctive RKI efficacy and additional review of its major ocular adverse events (AE) were also performed. Results Ten (2.6%) out of 391 studies were retrieved. In the RKI versus placebo class, RKI showed greater IOP reduction after 4–8 weeks (mean difference =  − 1.69 mmHg [− 2.22, − 1.16], P