Efficacy and safety of adding ripasudil to existing treatment regimens for reducing intraocular pressure

Abstract

Adding ripasudil to existing glaucoma treatment regimens is effective and safe in reducing IOP, regardless of the number of medications in use.

Intraocular Pressure-Lowering Effect of Ripasudil Hydrochloride Hydrate and Reasons for Discontinuation of Use in Clinical Practice

“…A prospective case series study by Inazaki, et al recruited 35 patients who had POAG and poor IOP control under maximally tolerated medications and found that the addition of ripasudil for 3 months resulted in a 2.8 mmHg IOP reduction on average [13], which is similar to our result of the magnitude of IOP reduction in patients with POAG being 2 mmHg. Similarly, Inoue, et al found the additive IOP-lowering effect of ripasudil in a total of 119 eyes of 119 patients with POAG or ocular hypertension, who had already used two or more anti-glaucoma medications [14]. In their study, the average IOP before the initiation of ripasudil application was 19.8 mmHg, while the IOP at 1 month and 3 months after the initiation was 17.5 and 16.8 mmHg, respectively [14].…”

“…Similarly, Inoue, et al found the additive IOP-lowering effect of ripasudil in a total of 119 eyes of 119 patients with POAG or ocular hypertension, who had already used two or more anti-glaucoma medications [14]. In their study, the average IOP before the initiation of ripasudil application was 19.8 mmHg, while the IOP at 1 month and 3 months after the initiation was 17.5 and 16.8 mmHg, respectively [14]. The present results of patients with POAG were also in agreement with their study.…”

“…There are, in the literature, 5 reports of clinical trials [7][8][9][10][11] and 4 reports of postmarketing clinical studies [13][14][15][16] regarding the IOP-lowering effect of ripasudil with 0.4% concentration. In terms of ripasudil monotherapy, the phase I clinical trial demonstrated that the single or 7-day instillation of ripasudil showed a 4-mmHg reduction of IOP 2 hours after the instillation in controls [7].…”

“…Limitations of this study were (1) The small sample size of each glaucoma type, particularly that of developmental glaucoma, (2) Incomplete access to data regarding steroid therapy regimen in the secondary glaucoma group due to the retrospective design, (3) No evaluation of placebo effect, (4) The possibility that the doctors In contrast, the 4 post-marketing clinical research studies evaluated the additive effect of ripasudil in eyes treated with multiple anti-glaucoma medications [13][14][15][16]. A prospective case series study by Inazaki, et al recruited 35 patients who had POAG and poor IOP control under maximally tolerated medications and found that the addition of ripasudil for 3 months resulted in a 2.8 mmHg IOP reduction on average [13], which is similar to our result of the magnitude of IOP reduction in patients with POAG being 2 mmHg.…”

One-Year Efficacy and Safety Assessment of Ripasudil, a Rho Kinase Inhibitor, in an Addition to or Replacing Existing Treatment Regimens: A Retrospective Study

“…[6][7][8][9][10][11] Ripasudil has a different IOP-lowering mechanism from the existing antiglaucoma instillations; therefore, it is expected to be used in combination with conventional antiglaucoma ophthalmic solutions. Although many studies have already reported the short-term IOP reduction and adverse effects associated with ripasudil treatment, [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] the long-term efficacy of ripasudil over more than 1 year has been addressed by only a few studies. 28,29 In addition, relatively few studies have evaluated the clinical factors affecting IOP reduction in cases wherein ripasudil was an addition to or a switch from the existing antiglaucoma instillations.…”