Two-Year Study Shows Real-World Effects of Latanoprostene Bunod

Latanoprostene bunod 0.024% effectively lowers intraocular pressure (IOP) and is safe for use in patients with glaucoma, according to a retrospective review conducted by researchers at New York Eye and Ear Infirmary of Mount Sinai in New York.

Researchers identified patients prescribed latanoprostene bunod 0.024% at an academic center between January 2018 and November 2019. The study included 102 eyes of 56 patients who met the inclusion criteria of an IOP measured at the visit latanoprostene bunod was prescribed and at 2 visits (≥7 days) after beginning treatment. Patients were excluded if they had undergone surgeries or laser procedures, or medication changes during follow-up. 

The mean IOP at the visit latanoprostene bunod 0.024% was prescribed was 16.2±4.3 mm Hg, and patients used on 3.2±1.5 glaucoma medications. IOP at the most recent visit was 13.7±3.8 mm Hg, with patients using 3.2±1.6 medications. Mean IOP reduction was 2.1±3.5 mm Hg (P <.0001) at first follow-up, after 38.7±36.5 days, and 2.5±3.3 mm Hg (P <.0001) at last follow-up, after 235.9±160.8 days. Pressure decreased by at least 2 mm Hg in 60% of eyes, by at least 3 mm Hg in 46%, and by at least 4 mm Hg in 34%. All patients received latanoprostene bunod 0.024% to replace a prostaglandin analog or latanoprost/netarsudil fixed-dose combination. In total, 43 patients used latanoprostene bunod throughout the follow-up period, 7 were discontinued for insufficient pressure control, 4 for adverse effects (including pain and itching), and 2 for financial reasons.

The research concludes that, after 2 years of use, 60% of patients exhibit statistically significant overall and clinically meaningful IOP reductions. 

The study’s authors noted several limitations to their work, including its retrospective design and lack of a control group. Additionally, no blinding was possible for this study, and IOP recordings were performed by both technicians and physicians, which may have caused variances. Further, they had no evidence that patient adherence to the medication regimen was unaltered during the study period, length of follow-up varied among participants, and the study was limited in sample size.

Many patients with glaucoma require treatment with more than 1 class of medication to control IOP. However, some of the older classes of medications cause side effects that decrease patient tolerability and compliance, frequency of dosing, and efficacy, according to investigators. Recently developed medications  — including latanoprostene bunod 0.024% — address these limitations. Latanoprostene bunod 0.024% is a prodrug of latanoprost and nitric oxide in a single formulation. It is indicated for lowering IOP in patients with open-angle glaucoma and ocular hypertension.

Disclosure: Some of the study’s authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Radell JE, Sharma HK, Auyeung KL, et al. Two-year experience with latanoprostene bunod in clinical practice. J Glaucoma. 2021;30(9):776-780. doi:10.1097/IJG.0000000000001904