Aerie Pharmaceuticals announced the publication of a peer-reviewed paper in eLife entitled, “Antifibrotic activity of a rho-kinase inhibitor restores outflow function and intraocular pressure homeostasis.” This paper evaluates the treatment effect of netarsudil, marketed as Rhopressa (netarsudil ophthalmic solution) 0.02% in the United States, on steroid-induced ocular hypertension in a mouse model and steroid-induced glaucoma in humans.
Findings from the mouse model demonstrate that netarsudil can reverse tissue stiffness and fibrosis in the trabecular meshwork caused by long term exposure to steroids, which is thought to mimic the effects of aging on the trabecular meshwork in patients with primary open angle glaucoma, according to an Aerie news release. The reduction of stiffness was demonstrated directly using atomic force microscopy, as well as indirectly in live mice by measuring the movement of the trabecular meshwork in response to elevated IOP. Importantly, this is the first time that a marketed glaucoma drug has shown the ability to potentially reverse pathology at the trabecular meshwork, doing so in a way that restores the trabecular meshwork to a more natural and flexible state. This is believed to be necessary for the trabecular meshwork to maintain IOP at a healthy level.
The paper also reviews clinical data for Rhopressa from retrospective chart reviews of two cohorts of patients with steroid induced glaucoma (“SIG”) whose IOP was not controlled on other medications. When Rhopressa was added, usually as a third or fourth medication, patients achieved an average decrease in IOP of 7 to 8 mmHg (millimeters of mercury).
“The findings of this independent research complement the substantial preclinical and clinical evidence that we have collected to date by demonstrating that Rhopressa acts directly on the trabecular meshwork to reduce tissue stiffness and improve outflow, thereby potentially reversing the fibrotic disease process associated with SIG and with primary open angle glaucoma,” Vicente Anido, Jr., PhD, Chairman and Chief Executive Officer at Aerie, said in the news release. “As the first glaucoma drug to demonstrate these effects on the outflow pathway responsible for elevated IOP in glaucoma, we believe that Rhopressa offers ophthalmologists a unique therapeutic tool for managing elevated IOP in their patients.”
Rhopressa was approved in the United States in December 2017 for the reduction of elevated IOP in patients with open-angle glaucoma or ocular hypertension. It has also received marketing authorization in the EU under the name Rhokiinsa.
The result of a research collaboration between investigators at Duke University, Georgia Institute of Technology/Emory University, Washington State University and Aerie Pharmaceuticals, Inc., the paper can be accessed from eLife’s website at http://www.elifesciences.org.