Benefit of omidenepag isopropyl ophthalmic solution in treatment persistence in Japanese patients with glaucoma

We conducted a retrospective observational cohort study using a nationwide claims database (JMDC database) to investigate the treatment persistence of antiglaucoma ophthalmic solution monotherapy. Patients aged 18 years or older who were diagnosed with glaucoma between November 2018 and August 2020, and prescribed omidenepag isopropyl (OMDI), prostaglandin F receptor agonists (FP), or beta-blockers (BB) monotherapies were included. A total of 36,450 patients (5,865 patients prescribed OMDI, 20,715 patients prescribed FP, and 9,870 patients prescribed BB) were analyzed. The cumulative treatment persistence rate at three years was 27.0% (95% confidence interval [CI]: 25.9–28.1) in patients prescribed OMDI, which was significantly higher than 20.9% (95% CI: 20.4–21.5) in those prescribed FP; the hazard ratio was 0.835 (95% CI: 0.806–0.865, p < 0.0001), calculated with the multivariate Cox proportional hazards model. The median duration of treatment persistence, calculated with the Kaplan-Meier methods, was 281 days in those prescribed OMDI, 204 days in those prescribed FP, and 152 days in those prescribed BB; the treatment persistence of OMDI tended to be longer than FP or BB. OMDI had a longer treatment persistence compared to other antiglaucoma ophthalmic solutions in the real-world setting, suggesting that OMDI would be a promising first-line treatment option in the long-term management of glaucoma.