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Editors Selection IGR 18-3

Medical Treatment: Latanoprostene Bunod efficacy

Comment by Norbert Pfeiffer on:

69393 Long-term Safety and Efficacy of Latanoprostene Bunod 0.024% in Japanese Subjects with Open-Angle Glaucoma or Ocular Hypertension: The JUPITER Study, Kawase K; Vittitow JL; Weinreb RN et al., Advances in Therapy, 2016; 33: 1612-1627

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At last there is hope that we will soon have a new IOP lowering drug for treating elevated IOP in subjects with glaucoma or ocular hypertension. Latanoprostene bunod sounds like the name of another prostaglandin. However, the authors state that "Following ocular instillation, LBN is rapidly metabolized into latanoprost acid, a prostaglandin F2&alfa; analog, and butanediol mononitrate, a nitric oxide (NO)-donating moiety, which is subsequently reduced to 1,4 butanediol, an inactive metabolite, and NO." Thus, this may be both a prostaglandine and a nitric oxide donating drug that appears to have mechanism of action which are different from other prostaglandin analogs. Kawasa and colleagues report their results from a single-arm, multi-center, open-label, clinical study in subjects with open-angle glaucoma or ocular hypertension. They observed the usual side-effects typical to prostaglandins with 62% having at least one topical side-effect. IOP lowering was 22% in study eyes and 19.5% in fellow eyes that were also treated after four weeks but also up to one year of follow-up. What does this mean? IOP lowering is in the range of other studies with prostaglandins. But data are from an open-label study. We look forward to a similar study with an active or placebo control. But: good news there is something new on the horizon.

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