March 06, 2018
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Rhopressa maintains noninferiority to timolol in trial

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NEW YORK — Once-daily Rhopressa treatment for patients with ocular hypertension or open-angle glaucoma consistently demonstrated IOP-lowering effects over 6 months and was noninferior to timolol, according to a speaker here.

“Netarsudil was noninferior at baseline pressures below 30 mm Hg, but also at lower baseline pressures, which is very important, below 27 mm Hg and below 25 mm Hg. When patients have a lower baseline pressure, medications struggle at being effective. This was noninferior to timolol even in patients with a baseline pressure below 25 mm Hg,” Albert Khouri, MD, told at the American Glaucoma Society annual meeting.

The Rocket 4 trial was a double-masked, randomized trial in patients with unmedicated IOP between 20 mm Hg and 30 mm Hg. Each trial arm included 186 patients who received once-daily Rhopressa (netarsudil 0.02%, Aerie Pharmaceuticals) or timolol maleate 0.5% for 6 months. Mean IOP was measured at week 2, week 5 and month 3 in patients with baseline IOP less than 25 mm Hg.

Rhopressa met its noninferiority endpoint at all time points up to month 3. Patients who received Rhopressa had a mean diurnal IOP between 16.8 mm Hg to 17.2 mm Hg compared with 16.9 mm Hg to 17.1 mm Hg for timolol.

“Timolol caused a reduction in heart rate, which was significant. This was not noted with netarsudil, so systemically it’s safe. The most common ocular adverse effect was hyperemia, but it was graded as mild in the majority of patients,” Khouri said.

Patients in the Rhopressa treatment arm experienced consistent IOP-lowering effects across baseline pressures over 6 months, he noted. – by Robert Linnehan



Khouri AS, et al. Once-daily netarsudil 0.02% vs. twice-daily timolol maleate 0.5% in ocular hypertension or open-angle glaucoma, the Rocket-4 study. Presented at: American Glaucoma Society annual meeting; Feb. 28 to March 4, 2018; New York.


Disclosure: Khouri reports he receives grant support from Allergan, Aerie Pharmaceuticals and NJ Health Foundation; receives lecture fees from Novartis, Allergan and Glaukos; and is a consultant for Topcon.