Real-world effectiveness and tolerability of fixed dose netarsudil/latanoprost in the management of patients with uncontrolled glaucoma

Abstract This prospective cohort study evaluates the real-world effectiveness and tolerability of the fixed-dose combination of Netarsudil 0.02%/Latanoprost 0.005% in patients with uncontrolled glaucoma. Following sample size determination, patients with any type of uncontrolled glaucoma were consecutively enrolled. Seventy-one eyes from forty patients (mean age 74.7 ± 10.0 years) were included. The median baseline IOP was 18.00 mmHg [IQR: 10], with an average of 2.76 ± 1.10 glaucoma medications. A statistically significant reduction in IOP was observed at each follow-up: 14.00 mmHg [IQR: 6.50] at 1 month ( p < 0.001), 13.00 mmHg [IQR: 8] at 3 months ( p < 0.001), and 13.50 mmHg [IQR: 7.75] at 6 months ( p < 0.001). Subgroup analysis revealed significant IOP reductions in patients with primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG). Adverse events were reported in 52.1% of treated eyes, most commonly worsening of conjunctival hyperemia (36.6%). Treatment discontinuation due to adverse events and inadequate IOP control occurred in 15.5% of eyes, respectively. Overall, the Netarsudil 0.02%/Latanoprost 0.005% combination demonstrated meaningful IOP reduction and a manageable safety profile in a real-world clinical setting, even in patients receiving maximally tolerated medical therapy. These findings suggest it may offer an alternative for patients who are not candidates or unwilling for surgical intervention.