The effectiveness and tolerability of fixed-dose combination netarsudil 0.02%/latanoprost 0.005% at a tertiary glaucoma center

• Published in: Graefe's archive for clinical and experimental ophthalmology 2023, Vol.261 (1), p.193-200
• Main Authors: Wong, Jae-Chiang, Shiuey, Eric J., Razeghinejad, Reza, Shukla, Aakriti G., Kolomeyer, Natasha N., Myers, Jonathan S., Pro, Michael J., Lee, Daniel
• Format: Article
• Language: English
• Subjects: Acuity; Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Drug dosages; Drug therapy; Eye; Glaucoma; Glaucoma - chemically induced; Glaucoma - diagnosis; Glaucoma - drug therapy; Glaucoma, Open-Angle - surgery; Humans; Hyperemia; Intolerance; Intraocular Pressure; Lasers; Latanoprost - adverse effects; Medicine; Medicine & Public Health; Middle Aged; Ocular Hypertension - drug therapy; Ophthalmology; Patients; Prostaglandins F, Synthetic - therapeutic use; Retrospective Studies; Surgery; Treatment Outcome
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-022-05780-w

Purpose To assess real-world effectiveness and tolerability of fixed-dose combination netarsudil 0.02%/latanoprost 0.005% (FCNL) in management of glaucoma patients in a tertiary eye care center. Methods This retrospective cohort study included glaucoma patients initiated on FCNL from January 2018 to July 2021 with at least 1-month follow-up. Demographic and clinical data were collected at baseline and at follow-up visits through 12 months. Patient-solicited side effects were recorded at each visit. Maximum glaucoma pharmacotherapy was defined as surgery/laser being the next treatment option following an intensive pharmacotherapy regimen, or when pharmacotherapy could not be increased due to allergy/intolerance or all pharmacologic mechanisms already being in use. Results Seventy-nine eyes of 47 patients were included. Mean age was 67.7 ± 14.7 years. Baseline IOP was 18.7 ± 4.9 mmHg; mean change in IOP (∆IOP) each study visit compared to baseline ranged from − 1.6 ± 3.5 to − 4.4 ± 4.1 mmHg (all p   0.2 for all). Forty-three (54.4%) eyes were switched from a prostaglandin analog alone, producing a 1-month IOP reduction of − 4.7 ± 3.9 mmHg at 1 month which remained significant at each visit for the 12-month study period (all p   0.05). Six (7.6%) and 7 (8.9%) eyes required further medical or surgical/laser intervention, respectively. Kaplan–Meier analysis revealed no significant difference in the need for subsequent medical or surgical intervention between those on maximum and non-maximal pharmacotherapy ( p  > 0.4). Conclusion FCNL was well-tolerated and demonstrated a significant and sustained reduction in IOP, even as last-line therapy before incisional or laser surgery in those on maximum glaucoma pharmacotherapy. FCNL is a viable treatment option for glaucomatous eyes before consideration of surgical intervention.