Abstract
Purpose :
To evaluate the real-world efficacy of netarsudil 0.02% ophthalmic solution dosed once daily before bed (q.h.s.) in reducing intraocular pressure (IOP) in eyes on multiple glaucoma medications.
Methods :
In this retrospective cohort study subject eyes recruited were patients at the New York Eye and Ear Infirmary of Mount Sinai (NYEEI) resident glaucoma clinic prescribed with netarsudil between November 2020 and February 2021. These eyes were diagnosed with glaucoma and had IOP above target despite being on ≥ 2 ocular hypotensive agents. Subject eyes were excluded if they were unable to tolerate or adhere to netarsudil for a period of 4-8 weeks after initiation of therapy. The main subject measure was the IOP-reducing effect of netarsudil after 4-8 weeks of therapy, with comparisons made between types of glaucoma and between eyes that did and did not have prior glaucoma surgery. Data was further assessed via t-test and interpreted as a percentage change in IOP.
Results :
Netarsudil was prescribed for 222 eyes. 50 eyes were excluded from analysis due to lack of adequate follow up or inability to adhere to therapy, leaving 172 eyes for analysis. 114 eyes had open angle glaucoma (OAG) and 17 had mixed mechanism glaucoma (MMG). The mean baseline IOP for eyes with OAG and those with MMG were 21.1 ± 5.8 mm Hg and 19.4 ± 5 mm Hg, respectively. After 4-8 weeks of treatment the mean IOP for eyes with OAG and those with MMG were 16.3 ± 4.8 mm Hg (p < 0.001) and 16.2 ± 4.6 mm Hg (p < 0.001), respectively. 110 eyes had prior glaucoma surgery and 62 had not. Mean baseline IOPs for eyes that did and did not have glaucoma surgery were 20.7 ± 5.9 mm Hg and 21.6 ± 5.7 mm Hg, respectively. After 4-8 weeks of treatment with netarsudil, the mean IOPs were 16.4 ± 5 mm Hg (p < 0.001) and 15.4 ± 4.5 mm Hg (p < 0.001), respectively.
Conclusions :
This study demonstrates that netarsudil is efficacious in eyes already on multiple glaucoma medications, regardless of the type of glaucoma or whether prior glaucoma surgery was performed and can help delay the need for incisional glaucoma surgery. This efficacy coexists with barriers to accessing and using the medication including cost and the burden of taking multiple ocular hypotensive drops. Patients indoubtedly benefit from the availability of netarsudil and particular attention should be paid to facilitating their ability to access it.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.