[ROCK (RHO-KINASE INHIBITORS) FOR THE TREATMENT OF OPEN-ANGLE GLAUCOMA AND OCULAR HYPERTENSION].

Harefuah Pub Date : 2023-03-01
Hagay Hagay, Asaf Achiron, Dua Maswuara, Mordechai Goldberg
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Abstract

Introduction: Netarsudil ophthalmic solution 0.02% is a new treatment for open-angle glaucoma and ocular hypertension, which was approved for treatment in the United States and in the European Commission. The drug is a rho- kinase inhibitor (ROCK) that lowers intraocular pressure by enhancing the outflow at the trabecular meshwork and decreasing both aqueous humor production and episcleral venous pressure. This literature review aims to present this new treatment, characterize its specific mechanism of action, and discuss its effect and adverse events profile. The efficacy and safety of the drug were studied in the ROCKET and MERCURY clinical trials, in which Netarsudil was compared to other common drugs, including Timolol (Beta-blocker), Latanoprost (Prostaglandin analog), and a combination drop containing Netarsudil and Latanoprost. These trials showed a reduction of 16%-21% in the intraocular pressure (IOP) when using Netarsudil. Moreover, it was found that when using a combination of Netarsudil and Latanoprost, 64.5% of these patients achieved ≥30% reduction in mean diurnal IOP versus 28.8% of patients treated only with Netarsudil and 37.2% of patients treated only with Latanoprost (P<0.0001). The most common adverse event reported was conjunctival hyperemia, which was more frequent in patients using Netarsudil. However, this did not significantly affect the drug tolerance.

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[rock (rho激酶抑制剂)治疗开角型青光眼和高眼压]。
0.02%奈沙地尔眼液是一种治疗开角型青光眼和高眼压的新药物,已在美国和欧盟获得批准。该药是一种rho激酶抑制剂(ROCK),通过增强小梁网的流出量和降低房水产生和锁膜外静脉压来降低眼压。这篇文献综述旨在介绍这种新的治疗方法,描述其具体的作用机制,并讨论其效果和不良事件概况。ROCKET和MERCURY临床试验研究了该药物的疗效和安全性,将奈沙地尔与其他常用药物,包括替莫洛尔(β受体阻滞剂)、拉坦前列素(前列腺素类似物)以及含有奈沙地尔和拉坦前列素的联合滴剂进行了比较。这些试验显示,使用奈沙地尔可使眼内压(IOP)降低16%-21%。此外,研究发现,当使用奈沙地尔和拉坦前列素联合使用时,64.5%的患者平均每日IOP降低≥30%,而仅使用奈沙地尔的患者为28.8%,仅使用拉坦前列素的患者为37.2% (P
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