Efficacy of the Additional Use of Ripasudil, a Rho-Kinase Inhibitor, in Patients With Glaucoma Inadequately Controlled Under Maximum Medical Therapy.
OBJECTIVE
The purpose of the study was to evaluate the intraocular pressure (IOP)-lowering effect and tolerability of ripasudil, a rho-kinase inhibitor, in patients with glaucoma inadequately controlled with maximum medical therapy.


METHODS
This prospective, noncomparative, interventional case series study included 35 patients with primary open angle glaucoma, in whom the glaucoma was poorly controlled with maximum medical therapy before starting the treatment with ripasudil. Ripasudil was instilled twice a day as adjunctive therapy to the ongoing glaucoma treatment. The primary end point was the degree of IOP reduction after 3 months of treatment, whereas the secondary end points were the percentage of patients reaching the predefined target IOP and the incidence of adverse events.


RESULTS
We examined 35 eyes of 35 patients with primary open angle glaucoma. The IOP reduction (relative percentage IOP reduction) from baseline was -2.8 mm Hg (-15.5%; 95% confidence interval, -1.6 to -3.9 mm Hg; P<0.001) after 3 months of treatment. The predefined target IOP was achieved in 48.5% (17/35) of the patients. The adverse events were conjunctival hyperemia (all patients), allergic conjunctivitis (2 patients), and ophthalmalgia (1 patient).


CONCLUSIONS
The addition of ripasudil was effective in lowering the IOP in patients with glaucoma poorly controlled with maximal medical therapy; moreover, the drug was well tolerated. In 48.5% of the patients in whom the predefined target IOP was achieved, this adjunctive therapy helped avoid glaucoma surgery at least in the short term.
Department of Ophthalmology and Microtechnology, Yokohama City University School of Medicine, Yokohama, Japan.
Hiroshi
H
Inazaki
Satoshi
S
Kobayashi
Yoko
Y
Anzai
Hisayoshi
H
Satoh
Shimpei
S
Sato
Maiko
M
Inoue
Shin
S
Yamane
Kazuaki
K
Kadonosono
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007546:Isoquinolines / Q000627:therapeutic use*; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy; D015814:Ocular Hypotension / Q000188:drug therapy; D011446:Prospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D014065:Tonometry, Ocular; D054460:rho-Associated Kinases / Q000037:antagonists & inhibitors*
D000959:Antihypertensive Agents; D004791:Enzyme Inhibitors; D007546:Isoquinolines; C584679:K-115; D013449:Sulfonamides; D054460:rho-Associated Kinases