Tan Jit Kai, Khaw Peng Tee, Henein Christin
Guy's Campus, King's College London, London SE1 1UL, UK.
Institute of Ophthalmology, University College London, London EC1V 9EL, UK.
Pharmaceuticals (Basel). 2025 Apr 3;18(4):523. doi: 10.3390/ph18040523.
: Primary open-angle glaucoma (POAG) is an anterior optic neuropathy that can lead to irreversible vision loss if untreated. Prostaglandin analogues are the first-line treatment, but new drug classes, such as rho kinase (ROCK) inhibitors, are being explored. This review evaluates the efficacy and safety of ROCK inhibitors in treating POAG based on completed trials, comparing results with available natural history data and identifying areas for further research. : A systematic database search was conducted in Ovid MEDLINE and Ovid Embase on 5 April 2022 using the following keywords: 'glaucoma', 'rho kinase inhibitor', 'rho-kinase inhibitor', 'rock inhibitor', 'ripasudil', 'netarsudil', and 'fasudil'. Abstracts were screened for relevant studies and results summarized in tables. : The analysis of trials conducted for ROCK inhibitors reveals that they are a safe and efficacious drug to treat POAG, demonstrating non-inferiority to existing medical treatments. Comparison of data to natural history studies was inconclusive due to the lack of natural history studies and their limitations. The results showed ROCK inhibitors to be effective when combined with existing medical treatments. However, questions remain regarding the optimal dosage, patient selection, and cost-effectiveness. Outcome measures for future trials should be expanded to include additional methods of monitoring disease progression as well as patient quality-of-life. : ROCK inhibitors have emerged with a favorable safety profile, efficaciously attenuating intraocular pressure. To elucidate their long-term therapeutic value and safety comprehensively, further independent, large-scale, prospective randomized controlled trials are warranted. Such studies are pivotal to augment our understanding of this emergent medication class.
原发性开角型青光眼（POAG）是一种前部视神经病变，若不治疗可导致不可逆的视力丧失。前列腺素类似物是一线治疗药物，但诸如 Rho 激酶（ROCK）抑制剂等新型药物类别正在探索中。本综述基于已完成的试验评估 ROCK 抑制剂治疗 POAG 的疗效和安全性，将结果与现有的自然病史数据进行比较，并确定进一步研究的领域。：2022 年 4 月 5 日在 Ovid MEDLINE 和 Ovid Embase 中进行了系统的数据库检索，使用以下关键词：“青光眼”、“Rho 激酶抑制剂”、“rho-激酶抑制剂”、“ROCK 抑制剂”、“ripasudil”、“netarsudil”和“fasudil”。筛选摘要以获取相关研究，并将结果汇总在表格中。：对 ROCK 抑制剂进行的试验分析表明，它们是治疗 POAG 的安全有效药物，显示出不劣于现有药物治疗。由于缺乏自然病史研究及其局限性，将数据与自然病史研究进行比较尚无定论。结果表明，ROCK 抑制剂与现有药物治疗联合使用时有效。然而，关于最佳剂量、患者选择和成本效益仍存在问题。未来试验的结局指标应扩大，以包括监测疾病进展的其他方法以及患者的生活质量。：ROCK 抑制剂已显示出良好的安全性，能有效降低眼压。为全面阐明其长期治疗价值和安全性，有必要进行进一步的独立、大规模、前瞻性随机对照试验。此类研究对于增强我们对这一新兴药物类别的理解至关重要。
