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ROCK Inhibition Mission

Provide power and simplicity for more glaucoma patients

Each patient living with OAG and OHT has unique treatment considerations. ROCK inhibitors, like Rhopressa®, work with the trabecular outflow pathway within the eye to reduce IOP levels and have proven to be efficacious in a variety of treatment regimens, making it possible to add versatility to more of your glaucoma patients’ treatments.1,2

How do ROCK Inhibitors work differently?

Within the trabecular meshwork, Rho kinase enzymes promote actin-myosin contraction and increase actin stress fibers and focal adhesions, increasing stiffness and causing resistance to aqueous flow.7

ROCK inhibitors work at the cellular level within the trabecular outflow pathway to relax actin-myosin. This causes relaxation within the trabecular meshwork and the inner wall of Schlemm's canal, and increases vasodilation within the episcleral venous system.8 Thus, Rhopressa® decreases IOP by improving aqueous humor outflow through the trabecular meshwork1,7 and decreasing episcleral venous pressure (EVP).3

CONTROL

SC=Schlemm’s canal

TM=Trabecular meshwork

Magnification of both images are identical.

+ NETARSUDIL

Expansion of TM structure

Human donor eyes with netarsudil M1 (active metabolite of netarsudil) or saline control

See ROCK Inhibition in action

Rhopressa® increased trabecular outflow by 35% and decreased EVP by ∼10%.9*

*In a clinical study with 20 OAG and OHT patients

View Dosing & Safety

QHS dosing exhibited a safe, tolerable performance and may help with adherence2,4

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

Bacterial Keratitis: There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products. These containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface.

Contact Lenses: Contact lenses should be removed prior to instillation of Rhopressa® and may be inserted 15 minutes following its administration.

ADVERSE REACTIONS

The most common ocular adverse reaction observed in controlled clinical studies with Rhopressa® dosed once daily was conjunctival hyperemia, reported in 53% of patients. Six percent of patients discontinued therapy due to conjunctival hyperemia. Other common (approximately 20%) adverse reactions were: corneal verticillata, instillation site pain, and conjunctival hemorrhage. Instillation site erythema, corneal staining, blurred vision, increased lacrimation, erythema of eyelid, and reduced visual acuity were reported in 5-10% of patients.

The corneal verticillata seen in Rhopressa®- treated patients were first noted at 4 weeks of daily dosing. This reaction did not result in any apparent visual functional changes. Most corneal verticillata resolved upon discontinuation of treatment.

Please click here for full prescribing information for Rhopressa®.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

INDICATIONS AND USAGE

Rhopressa® (netarsudil ophthalmic solution) 0.02% is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.

DOSAGE AND ADMINISTRATION

The recommended dosage is one drop in the affected eye(s) once daily in the evening.

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

Bacterial Keratitis: There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products. These containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface.

Contact Lenses: Contact lenses should be removed prior to instillation of Rhopressa® and may be inserted 15 minutes following its administration.

ADVERSE REACTIONS

The most common ocular adverse reaction observed in controlled clinical studies with Rhopressa® dosed once daily was conjunctival hyperemia, reported in 53% of patients. Six percent of patients discontinued therapy due to conjunctival hyperemia. Other common (approximately 20%) adverse reactions were: corneal verticillata, instillation site pain, and conjunctival hemorrhage. Instillation site erythema, corneal staining, blurred vision, increased lacrimation, erythema of eyelid, and reduced visual acuity were reported in 5-10% of patients.

The corneal verticillata seen in Rhopressa®- treated patients were first noted at 4 weeks of daily dosing. This reaction did not result in any apparent visual functional changes. Most corneal verticillata resolved upon discontinuation of treatment.

Please click here for full prescribing information for Rhopressa®.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

INDICATIONS AND USAGE

Rhopressa® (netarsudil ophthalmic solution) 0.02% is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.

DOSAGE AND ADMINISTRATION

The recommended dosage is one drop in the affected eye(s) once daily in the evening.

References:

  1. Rhopressa® (netarsudil ophthalmic solution) 0.02% Prescribing Information, Aerie Pharmaceuticals, Inc., Irvine, Calif. 2019.
  2. Data on file, Aerie Pharmaceuticals, Inc.
  3. Kazemi A, McLaren J, Kopczynski C, et al. The effects of netarsudil ophthalmic solution on aqueous humor dynamics in a randomized study in humans. J Ocul Pharmacol Ther. 2018;34(5):380-386.
  4. Prum B Jr, Rosenberg L, Gedde S, et al. Primary Open-Angle Glaucoma Preferred Practice Pattern guidelines. Ophthalmology. 2016;123(1):P41-P111.
  5. Serle JB, Katz LJ, McLaurin E, et al. Two Phase 3 clinical trials comparing the safety and efficacy of netarsudil to timolol in patients with elevated intraocular pressure: Rho kinase elevated IOP treatment Trial 1 and 2 (ROCKET-1 and ROCKET-2). Am J Ophthalmol. 2018;186:116-127.
  6. Khouri AS, Serle JB, Bacharach J, et al; for the ROCKET-4 Study Group. Once-daily netarsudil vs twice-daily timolol in patients with elevated intraocular pressure: the randomized phase 3 ROCKET-4 study. Am J Ophthalmol. 2019;204:97-104.
  7. Wang R, Williamson J, Kopczynski C, Serle J. Effect of 0.04% AR-13324, a ROCK, and norepinephrine transporter inhibitor, on aqueous humor dynamics in normotensive monkey eyes. J Glaucoma. 2015;24(1):51-54.
  8. Ren R, Li G, Le TD, Kopczynski C, Stamer WD, Gong H. Netarsudil increases outflow facility in human eyes through multiple mechanism. IOVS. 2016;(57)14:6197-6209.
  9. Sit A, Gupta D, Kazemi A, et al. Improvement of trabecular outflow facility by netarsudil ophthalmic solution in patients with primary open angle glaucoma or ocular hypertension. Presented at The Association for Research in Vision and Ophthalmology 2019 Annual Meeting (ARVO 2019). April 28-May 2, 2019; Vancouver, BC, Canada.
  10. Managed Market Insights & Technology, May 2020.