Whilst in recent years we have seen an explosion of new surgical techniques for glaucoma management, the same cannot be said for glaucoma medication. The last big development with glaucoma eye drops was over 10 years ago, however that may be about to change. A new class of medication, called Rho-kinase inhibitors, has been tested over the past few years and the outcome of a recent clinical trial raises the possibility that it will be come available soon.
Rocket 1, a phase 3 clinical trial assessed the efficacy of a new medication, Rhopressa, on intra-ocular pressure lowering. It was compared against timolol, a medication that is widely available and has been used for glaucoma for many decades. The aim of the trial was to show that the new treatment was not inferior to timolol. Initial reports suggest this was not the case (ie: the study failed to demonstrate non-inferiority). However, closer scrutiny of the data shows that Rhopressa was equal to timolol in eyes where the eye pressure before treatment was less than 26mmHg. As the majority of patients with glaucoma have pre-treatment pressures within this range, it follows that Rhopressa may in fact be a beneficial treatment for many glaucoma patients.
Another trial, examining the effectiveness of a treatment combining a Rho-kinase inhibitor and a prostaglandin analogue (Roclatan), will begin later this year.