Ripasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection

Sentaro Kusuhara, Makoto Nakamura Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe 650-0017, JapanCorrespondence: Sentaro KusuharaDepartment of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo...

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Autores principales:	Kusuhara S, Nakamura M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	ripasudil glaucoma intraocular pressure efficacy safety Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/a8336d666cdd4c7b9e28933c1afc0e0a
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spelling	oai:doaj.org-article:a8336d666cdd4c7b9e28933c1afc0e0a2021-12-02T09:57:27ZRipasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection1177-5483https://doaj.org/article/a8336d666cdd4c7b9e28933c1afc0e0a2020-05-01T00:00:00Zhttps://www.dovepress.com/ripasudil-hydrochloride-hydrate-in-the-treatment-of-glaucoma-safety-ef-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Sentaro Kusuhara, Makoto Nakamura Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe 650-0017, JapanCorrespondence: Sentaro KusuharaDepartment of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanTel +81-78-382-6048Fax +81-78-382-6059Email kusu@med.kobe-u.ac.jpAbstract: Reduction of intraocular pressure (IOP) is the only reliable treatment for glaucoma that maintains the patient’s visual function throughout life, and IOP-lowering eyedrops are the mainstay of therapy. Ripasudil hydrochloride hydrate (brand name: Glanatec ophthalmic solution 0.4%; Kowa Company, Ltd., Japan) is a Rho-associated coiled-coil-containing protein kinase (ROCK) inhibitor that lowers IOP by increasing conventional aqueous outflow. Since the approval of ripasudil eyedrops in 2014, a large store of clinical data has been amassed in Japan. With regard to safety, conjunctival hyperemia is the most common adverse drug reaction (ADR) and is usually transient and mild. Blepharitis and allergic conjunctivitis are other major local ADRs. Systemic ADRs are rare, but we should be wary of allergic reactions. With regard to efficacy, ripasudil is expected to lower IOP in almost all glaucoma subtypes (including primary open-angle glaucoma, secondary glaucoma, and primary angle-closure glaucoma) and in all patterns of treatment initiation (monotherapy, combination therapy, switching therapy, and add-on therapy). However, the status of the trabecular meshwork may affect the IOP-lowering effect of ripasudil. In patient selection, current evidence-based information on the safety and efficacy of ripasudil should be fully considered. As irreversible damage to the trabecular meshwork would considerably affect efficacy, it may be better to start ripasudil treatment during an early stage of glaucoma.Keywords: ripasudil, glaucoma, intraocular pressure, efficacy, safetyKusuhara SNakamura MDove Medical Pressarticleripasudilglaucomaintraocular pressureefficacysafetyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 1229-1236 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	ripasudil glaucoma intraocular pressure efficacy safety Ophthalmology RE1-994
spellingShingle	ripasudil glaucoma intraocular pressure efficacy safety Ophthalmology RE1-994 Kusuhara S Nakamura M Ripasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection
description	Sentaro Kusuhara, Makoto Nakamura Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe 650-0017, JapanCorrespondence: Sentaro KusuharaDepartment of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanTel +81-78-382-6048Fax +81-78-382-6059Email kusu@med.kobe-u.ac.jpAbstract: Reduction of intraocular pressure (IOP) is the only reliable treatment for glaucoma that maintains the patient’s visual function throughout life, and IOP-lowering eyedrops are the mainstay of therapy. Ripasudil hydrochloride hydrate (brand name: Glanatec ophthalmic solution 0.4%; Kowa Company, Ltd., Japan) is a Rho-associated coiled-coil-containing protein kinase (ROCK) inhibitor that lowers IOP by increasing conventional aqueous outflow. Since the approval of ripasudil eyedrops in 2014, a large store of clinical data has been amassed in Japan. With regard to safety, conjunctival hyperemia is the most common adverse drug reaction (ADR) and is usually transient and mild. Blepharitis and allergic conjunctivitis are other major local ADRs. Systemic ADRs are rare, but we should be wary of allergic reactions. With regard to efficacy, ripasudil is expected to lower IOP in almost all glaucoma subtypes (including primary open-angle glaucoma, secondary glaucoma, and primary angle-closure glaucoma) and in all patterns of treatment initiation (monotherapy, combination therapy, switching therapy, and add-on therapy). However, the status of the trabecular meshwork may affect the IOP-lowering effect of ripasudil. In patient selection, current evidence-based information on the safety and efficacy of ripasudil should be fully considered. As irreversible damage to the trabecular meshwork would considerably affect efficacy, it may be better to start ripasudil treatment during an early stage of glaucoma.Keywords: ripasudil, glaucoma, intraocular pressure, efficacy, safety
format	article
author	Kusuhara S Nakamura M
author_facet	Kusuhara S Nakamura M
author_sort	Kusuhara S
title	Ripasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection
title_short	Ripasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection
title_full	Ripasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection
title_fullStr	Ripasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection
title_full_unstemmed	Ripasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection
title_sort	ripasudil hydrochloride hydrate in the treatment of glaucoma: safety, efficacy, and patient selection
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/a8336d666cdd4c7b9e28933c1afc0e0a
work_keys_str_mv	AT kusuharas ripasudilhydrochloridehydrateinthetreatmentofglaucomasafetyefficacyandpatientselection AT nakamuram ripasudilhydrochloridehydrateinthetreatmentofglaucomasafetyefficacyandpatientselection
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Ripasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection

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