title: Open-Angle Glaucoma: Drug Development Pipeline during the Last 20 Years (1995-2015).
abstract: OBJECTIVE
  To analyse drug development for open-angle glaucoma during the last 20 years.
  
  
  METHODS
  Research was performed by referring to clinical trials registered at the International Clinical Trials Registry Platform (ICTRP). A search for the condition "open-angle glaucoma" with the intervention "drug" was performed. We included trials registered from 01/01/1995 to 01/01/2015, only involving studies in phases 1, 2, and 3. Only studies resorting to novel treatment strategies (either novel drugs or yet-untested fixed associations of approved medication) were considered.
  
  
  RESULTS
  We recorded 158 studies for the condition of open-angle glaucoma with a drug-based intervention; 65 of the studies reported phase 2 trials and 74 reported phase 3 trials. Pharmaceutical companies were the primary sponsors of 95.3% of the trials. Most of the studies (66.5%, n = 105) involved a new drug, and the remainder (33.5%, n = 53) tested fixed drug associations. The bulk of the trials (n = 99, 62.7%) involved the use of prostaglandin analogues, either as a comparator or a study drug. In descending order of frequency, the studies conducted involved Rho-kinase inhibitors (n = 15), carbonic anhydrase inhibitors (n = 14), β-blockers (n = 7), angiostatic steroids (n = 6), α2-adrenergic agonists (n = 4), 5-HT2A receptor agonists (n = 4), and NMDA receptor antagonists (n = 2). A cyclin-dependent kinase inhibitor, an LIM-domain kinase 2 inhibitor, an A1 adenosine receptor agonist, catechin, macrolide, saffron, and seawater were each tested in 1 clinical trial.
  
  
  CONCLUSIONS
  Research into the medical treatment of glaucoma indicates the use of prostaglandin analogues. However, there are a significant number of trials testing other drug classes, particularly Rho-kinase inhibitors. This new focus could lead to a potential increase in the number of therapeutical options for the management of glaucoma in the future.
authors.affiliation: Ophthalmology, Department of Clinical Sciences, Umeå University, Umeå, Sweden.
authors.forename: André
authors.initials: A
authors.lastname: Vicente
authors.forename: Sylvie
authors.initials: S
authors.lastname: Prud'homme
authors.forename: Joana
authors.initials: J
authors.lastname: Ferreira
authors.forename: Luís
authors.initials: L
authors.lastname: Abegão Pinto
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Stalmans
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use*; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D016032:Randomized Controlled Trials as Topic; D012042:Registries
chemical_list: D000319:Adrenergic beta-Antagonists; D002257:Carbonic Anhydrase Inhibitors