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Additive Intraocular Pressure Lowering Effects of the Rho Kinase Inhibitor, Ripasudil in Glaucoma Patients Not Able to Obtain Adequate Control After Other Maximal Tolerated Medical Therapy

Abstract

Introduction

The aim of this study is to investigate the additive intraocular pressure (IOP)-lowering effects and safety of the selective Rho kinase inhibitor, 0.4% ripasudil, in patients with glaucoma not adequately controlled by other maximal tolerated medical therapies.

Methods

We retrospectively reviewed 92 glaucoma patients who received ripasudil as an additive glaucoma treatment. In spite of receiving prior maximal tolerated medical therapies, all patients had uncontrolled glaucoma before receiving ripasudil. IOP was recorded at all follow-up dates.

Results

The study population consisted of 43 primary open-angle glaucoma (POAG), 28 normal-tension glaucoma (NTG), ten secondary glaucoma, seven exfoliation glaucoma, and four developmental glaucoma patients. After ripasudil administration, there was a significant decrease in the IOP. The mean pre-administration IOP and % IOP reduction at the last follow-up were 19.7 ± 4.9 mmHg and 6.5 ± 17.0% for POAG, 15.5 ± 2.0 mmHg and 2.3 ± 10.4% for NTG, 22.8 ± 8.3 mmHg and 19.1 ± 13.5% for secondary glaucoma, 22.5 ± 4.4 mmHg and 2.1 ± 14.5% for exfoliation glaucoma, and 20.2 ± 8.9 mmHg and 11.4 ± 23.1% for developmental glaucoma, respectively. Side effects led to ripasudil discontinuation in 13 patients, with five exhibiting an allergic reaction, six developing blepharitis, and two having a burning sensation.

Conclusions

Use of ripasudil as an adjunctive therapy resulted in lowering of the IOP. Ripasudil was well tolerated.

Funding

Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (26462689).

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Acknowledgments

Sponsorship and article processing charges for this study were funded by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (26462689).

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.

Data collection and analysis of this manuscript was provided by Dr. Shino Sato.

Writing of this manuscript was provided by Dr. Kazuyuki Hirooka.

Editing assistance of this manuscript was provided by Dr. Eri Nitta, Dr. Kaori Ukegawa and Dr. Akitaka Tsujikawa.

Disclosures

Shino Sato, Kazuyuki Hirooka, Eri Nitta, Kaori Ukegawa, and Akitaka Tsujikawa have nothing to disclose.

Compliance with Ethics Guidelines

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1964, as revised in 2013. Informed consent was obtained from all patients for being included in the study.

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Correspondence to Kazuyuki Hirooka.

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Sato, S., Hirooka, K., Nitta, E. et al. Additive Intraocular Pressure Lowering Effects of the Rho Kinase Inhibitor, Ripasudil in Glaucoma Patients Not Able to Obtain Adequate Control After Other Maximal Tolerated Medical Therapy. Adv Ther 33, 1628–1634 (2016). https://doi.org/10.1007/s12325-016-0389-3

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  • DOI: https://doi.org/10.1007/s12325-016-0389-3

Keywords

  • Glaucoma
  • Intraocular pressure
  • Ophthalmology
  • Ripasudil