New Class of Glaucoma Drugs on the Horizon

Summary: A new class of glaucoma drugs, Rho kinase inhibitors, promises to act specifically on the eye’s drainage canals, called the trabecular meshwork, a main outflow and blockage site in glaucoma.

Primary Open Angle Glaucoma is the most common type of glaucoma. An increase in eye pressure, intraocular pressure (IOP), occurs slowly over time leading to vision loss.

Higher IOP is thought to be the result of changes in the eye that lead to an obstruction in the outflow of fluid. Large clinical studies have shown that, with reduction in IOP, retinal damage and progressive visual loss can be slowed or minimized.

About Glaucoma Therapies

Current drug treatments are directed towards lowering IOP. Treatments to reduce IOP rely on topical eye drop medications, laser and or conventional surgery. Many patients require more than one drug to control IOP, and despite effective current therapies, they don’t work for all patients.

Current glaucoma medications reduce IOP by either reducing the production of fluid in the eye, or by increasing its outflow. Prostaglandins, which increase outflow, are now the most prescribed glaucoma treatment worldwide.

New Glaucoma Drugs

A new class of glaucoma drugs promises to act specifically on the eye’s drainage canals, called the trabecular meshwork, a main outflow and blockage site in glaucoma. Rho kinase (ROCK) inhibitors target cells in the trabecular meshwork to enhance aqueous humor outflow. Aqueous humor is a clear fluid that maintains the intraocular pressure.

In research models of glaucoma, ROCK inhibitors have been shown to reduce cellular “stiffness” and enhance outflow through the trabecular meshwork, thereby reducing IOP. No drugs currently on the market enhance the eye’s fluid outflow in this way. Therefore this is a novel and unique target and approach to lowering IOP.

ROCK inhibitors are not yet approved and available for glaucoma patients. Two US companies, Aerie and Altheos, are currently in early clinical research development with topical ROCK inhibitors to lower IOP.

Research data has shown that ROCK inhibition has the potential to offer neuroprotective and anti-inflammatory effects as well as enhance blood flow to the optic nerve, all of which could benefit glaucoma patients. The glaucoma community looks forward to and awaits the clinical research data as it becomes available for this potentially exciting class of drug compounds.
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Article by Barbara Wirostko, MD, Clinical Adjunct Associate Professor at the University of Utah, Moran Eye Center, in Salt Lake City, Utah. She serves as the Chief Medical Officer of Altheos, Inc., a company developing a topical ROCK inhibitor.

Last reviewed on April 22, 2013

This article appeared in the May 2012 issue of Gleams. Subscribe

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