Abstract
Purpose :
Netarsudil has been shown to reduce intraocular pressure (IOP) alone and in combination with latanoprost in clinical trials. However, little is known about the efficacy of netarsudil in combination with other ocular hypotensive agents. This study assesses the efficacy, safety, and tolerability of netarsudil in clinical practice at a tertiary care medical center.
Methods :
All patients treated with netarsudil 0.2% once-daily and at least 1 other ocular hypotensive agent during a 14 month period from 2017−2019 at the Northwestern Medical Group were identified using an institutional electronic warehouse of all clinical data. After reviewing electronic medical records, patients were excluded if they had less than one month of follow-up, had other changes in their ocular hypotensive medication regimen, or were previously using netarsudil. Only patients with at least one visit before and after initiation of netarsudil were included.
Results :
275 eyes of 197 patients treated with netarsudil on adjunctive therapy were identified. The mean age was 67.5 (±11.9) years. Most patients were female (N=98, 49.8%), Caucasian (N=_138, 70.1%) and had either primary open angle glaucoma (N=106, 53.8%) or normal-tension glaucoma (N=36, 18.3%) with either severe- (N=80, 40.8%) or moderate-stage (N=63, 32.1%) disease. The majority of patients tolerated netarsudil (N=155, 78.7 %). Nearly half experienced side effects (N=96, 48.7%), the most common being conjunctival hyperemia (N=55, 27.9%) or blurry vision (N=20, 10.5%).
IOP was significantly lower after netarsudil (N=275; mean IOP reduction 2.3 mmHg from a baseline of 18.0 mmHg; p<0.001). There were significant mean IOP reductions for patients on 1 other agent (N=77; IOP reduction of 1.9 from 17.4; p<0.001); for patients on 2 other agents (N=61; IOP reduction of 1.7 from 16.7; p=0.002); for patients on 3 other agents (N=85; IOP reduction of 2.6 from 18.0; p<0.001); and for patients on 4 other agents (N=49; IOP reduction of 3.3 from 20.3; p<0.001).
Conclusions :
The study showed clinically and statistically significant IOP reduction after the addition of netarsudil in conjunction with other ocular hypotensive agents. In particular, the largest mean IOP reduction was seen in patients on 4 other medications. These results suggest that netarsudil is often tolerated and effective as an adjunctive ocular hypotensive agent, even when added to a regimen of four topical agents.
This is a 2020 ARVO Annual Meeting abstract.