Netarsudil 0.02% Lowers Intraocular Pressure in Secondary Glaucoma

Netarsudil 0.02% can lower intraocular pressure (IOP) in individuals with secondary glaucoma, particularly those with uveitic glaucoma, according to research published in the Canadian Journal of Ophthalmology. 

Researchers conducted a retrospective investigation that included patients (N=77) who were treated with netarsudil 0.02% during the course of 1 year between March 2020 to January 2021. Among the study participants, 32 had primary open angle glaucoma (POAG; mean age, 69.1 years; 41% women) and 45 had forms of secondary glaucoma (mean age, 64.5 years; 51% women), which included uveitic glaucoma (n=14), pseudoexfoliative glaucoma (n=9), neovascular glaucoma (n=5), congenital glaucoma (n=5), and other forms of secondary glaucoma (n=12). Study participants underwent IOP measurements at baseline and at 1-, 3-, 6-, and 12-month visits after initiating netarsudil 0.02% treatment. 

IOP differences from baseline were significant at all time points in both groups, according to the report, and participants with POAG showed a similar IOP reduction compared with patients with secondary glaucoma at 1 year (6.0 vs 6.6 mm Hg). No significant differences were noted between the 2 cohorts with respect to race, sex, and comorbidities. 

However, there were marked differences between the 2 groups at the study conclusion — 46% of participants with POAG achieved an IOP of less than 14 mm Hg compared with 17% of patients with secondary glaucoma. Furthermore, 42% of patients with secondary glaucoma had an IOP greater than 20 mm Hg at the study conclusion compared with 11% of patients with POAG. 

Among secondary glaucoma subtypes, netarsudil 0.02% demonstrated the greatest efficacy for uveitic glaucoma treatment. Patients with this subtype who were treated with the drug had statistically significant IOP reductions in as little as 6 months (P =.01) and experienced a total IOP drop of 9.5 mm Hg at 12 months (P =.01).

“[T]he results of this investigation demonstrate netarsudil’s effectiveness in lowering IOP in patients with secondary forms of glaucoma,” according to the researchers. “The reductions in IOP from baseline were significant at all time points in all secondary glaucoma subgroups. Additionally, the secondary glaucoma patients achieved similar overall reductions in IOP when compared with POAG patients after 12 months of treatment.”

Study limitations include a small sample size and a high loss to follow up.