The effectiveness and safety profile of netarsudil 0.02% in glaucoma treatment: real-world 6-month outcomes

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 260; no. 3; pp. 967 - 974
• Main Authors: Shiuey, Eric J., Mehran, Nikki A., Ustaoglu, Melih, Zhang, Qiang, Razeghinejad, Reza, Shukla, Aakriti G., Kolomeyer, Natasha N., Myers, Jonathan S., Lee, Daniel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2022; Springer Nature B.V
• Subjects: Acuity; Aged; Aged, 80 and over; Benzoates; beta-Alanine - analogs & derivatives; Eye; Glaucoma; Glaucoma - drug therapy; Glaucoma, Open-Angle - drug therapy; Humans; Hyperemia; Intraocular Pressure; Lasers; Medicine; Medicine & Public Health; Middle Aged; Ocular Hypertension - drug therapy; Ophthalmic Solutions; Ophthalmology; Patients; Retrospective Studies; Side effects; Treatment Outcome; Vision; Glaucoma; Intraocular pressure; Netarsudil; Rho kinase inhibitors
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-021-05410-x

Purpose To evaluate the efficacy and safety profile of netarsudil 0.02% ophthalmic solution in a tertiary glaucoma referral center. Methods This retrospective cohort study included patients with glaucoma initiated on netarsudil 0.02% at a single institution from November 2017 to September 2018. Demographic and clinical data were collected, including intraocular pressure (IOP) and drug side effects at baseline and 1-, 3-, and 6-month follow-up visits. Results A total of 340 eyes of 233 patients were included; mean ± SD patient age was 69.1 ± 12.5 years. One hundred twenty (48%) eyes experienced ≥ 20% decreases in IOP at the 1-month study visit; this effect was maintained through the 6-month visit. IOP-lowering effects in patients using ≥ 3 topical glaucoma medications were similar (all p  > 0.1). Eighteen (7.4%) and 7 (2.9%) patients experienced increases in IOP of ≥ 3 and ≥ 5 mmHg, respectively. Across all study visits, conjunctival hyperemia was noted at a rate of 27.6%, and though frequently reported, complaints of blurred vision (31.1%) did not manifest in significant worsening of visual acuity. The rate of drug discontinuation due to insufficient IOP-lowering and side effects was 15.6% and 24.8%, respectively. Twenty-nine (11.4%) and 82 (32.3%) eyes required additional medical and surgical/laser intervention, respectively. Conclusion Commonly used as the last-line medical therapy in this case series, netarsudil safely and significantly reduced IOP in patients with glaucoma, even in those using ≥ 3 glaucoma medications. Increases in IOP of ≥ 3 mmHg occurred in a small number of patients. Subjective vision changes and conjunctival hyperemia were the most frequently reported side effects.