Stamer W Daniel, Chiu Thomas, Lu Da-Wen, Wang Tsing Hong, Rojanapongpun Prin, Ruangvaravate Ngamkae, Jo Youn Hye, Moster Marlene R, Fingeret Murray, Cothran Nora Lee, Steen Jessica, Gaddie Ian Benjamin, Uçakhan-Gündüz Ömür, Shamseldin Shalaby Wesam, Hutnik Cindy M L
Department of Ophthalmology, School of Medicine, Duke University, Durham, NC, United States.
The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, Hong Kong SAR, China.
Front Ophthalmol (Lausanne). 2025 Mar 28;5:1554777. doi: 10.3389/fopht.2025.1554777. eCollection 2025.
Latanoprostene bunod ophthalmic solution (LBN) 0.024% is a topical nitric oxide (NO)-donating prostaglandin F2α (PGF2α) analog first approved in November 2017 for reduction of intraocular pressure (IOP) in patients with ocular hypertension (OHT) or open-angle glaucoma (OAG). This narrative review describes the unique mechanism of action of LBN and summarizes available real-world data. Upon instillation, LBN is metabolized into latanoprost acid and butanediol mononitrate, which is further reduced to NO and an inactive metabolite. Latanoprost acid increases aqueous humor outflow primarily through the uveoscleral (unconventional) pathway, whereas NO increases outflow through the trabecular (conventional) pathway. Eight studies were identified: 2 studies in newly diagnosed, treatment-naïve patients with OHT or OAG, 4 studies of adjunctive therapy in patients with glaucoma receiving other IOP-lowering therapies, and 2 studies in which patients with glaucoma switched to LBN monotherapy or adjunctive therapy. Decreases in IOP after initiating LBN in newly diagnosed patients or adding/switching to LBN were generally consistent with reductions observed in clinical trials and sustained throughout the studies. Rates of discontinuation due to inadequate IOP lowering ranged from 12.2% to 17.1%. LBN was generally well tolerated in real-world studies; the most common adverse events were consistent with the known safety profile of LBN. Data from real-world studies provide important insights regarding the potential effectiveness and tolerability of LBN in the clinical setting and suggest that LBN is well tolerated and associated with significant, clinically meaningful, and durable reductions in IOP.
0.024%的布诺前列素拉坦前列素滴眼液（LBN）是一种局部给药的一氧化氮（NO）供体型前列腺素F2α（PGF2α）类似物，于2017年11月首次获批用于降低高眼压症（OHT）或开角型青光眼（OAG）患者的眼压（IOP）。本叙述性综述描述了LBN独特的作用机制，并总结了现有的真实世界数据。滴入后，LBN代谢为拉坦前列素酸和丁二醇单硝酸盐，后者进一步还原为NO和一种无活性代谢物。拉坦前列素酸主要通过葡萄膜巩膜（非常规）途径增加房水流出，而NO通过小梁（常规）途径增加流出。共确定了八项研究：两项针对初诊、未接受过治疗的OHT或OAG患者的研究，四项针对接受其他降眼压治疗的青光眼患者的辅助治疗研究，以及两项青光眼患者改用LBN单药治疗或辅助治疗的研究。新诊断患者开始使用LBN后或添加/改用LBN后眼压的降低通常与临床试验中观察到的降低一致，且在整个研究过程中持续存在。因眼压降低不足而停药的比例在12.2%至17.1%之间。在真实世界研究中LBN总体耐受性良好；最常见的不良事件与LBN已知的安全性特征一致。真实世界研究的数据为LBN在临床环境中的潜在有效性和耐受性提供了重要见解，并表明LBN耐受性良好，与眼压显著、具有临床意义且持久的降低相关。
