Additive intraocular pressure-lowering effects of the Rho kinase inhibitor ripasudil in Japanese patients with various subtypes of glaucoma

Jpn J Ophthalmol. 2019 Jan;63(1):40-45. doi: 10.1007/s10384-018-0635-0. Epub 2018 Oct 28.

Abstract

Purpose: The present study aimed to investigate the effectiveness of adjunctive therapy involving the Rho-associated, coiled-coil-containing protein kinase (ROCK) inhibitor ripasudil in lowering intraocular pressure (IOP) in patients with different subtypes of glaucoma, on the basis of the time of IOP measurement STUDY DESIGN: Retrospective study METHODS: In total, 58 patients who underwent adjunctive therapy with ripasudil at a single institution were included. They were classified into a primary open-angle glaucoma (POAG) group, an exfoliation glaucoma (XFG) group, and a secondary glaucoma associated with uveitis, or steroid glaucoma (SG), group. The average IOPs within 6 months before (pre-IOP) and after (post-IOP) the addition of ripasudil were compared among the 3 groups. The IOP values of the morning-visit and afternoon-visit groups were also compared to reflect the peak effectiveness of ripasudil.

Results: The IOP reductions in the POAG (n = 38), XFG (n = 6), and SG (n = 14) groups were -1.1, +0.5, and +0.5 mmHg, respectively. Significant reductions in IOP were observed in the POAG group (P = .014). The IOP reductions in the POAG morning-visit and afternoon-visit groups were -1.9 and +0.5 mmHg, respectively. IOP was significantly reduced in the morning-visit POAG group after treatment with ripasudil (P = .002). The IOP values measured during morning visits were lower than those measured during afternoon visits (IOP reduction: -1.3 mmHg; P = .011).

Conclusions: The findings of the present study indicate that ripasudil is effective as an adjunctive therapy for lowering IOP in patients with POAG; these reductions are more significant when measured closer to the time of peak effectiveness.

Keywords: Glaucoma; Intraocular pressure; Rho-kinase inhibitor; Ripasudil.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Glaucoma / drug therapy*
  • Glaucoma / epidemiology
  • Glaucoma / physiopathology
  • Humans
  • Incidence
  • Intraocular Pressure / drug effects*
  • Isoquinolines / administration & dosage*
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Ophthalmic Solutions / administration & dosage
  • Retrospective Studies
  • Sulfonamides / administration & dosage*
  • Time Factors
  • Treatment Outcome
  • rho-Associated Kinases / antagonists & inhibitors*

Substances

  • Isoquinolines
  • K-115
  • Ophthalmic Solutions
  • Sulfonamides
  • rho-Associated Kinases