Latanoprostene bunod: the first nitric oxide-donating antiglaucoma medication

Ghazaleh Soltani, Wesam Shamseldin Shalaby, Reza Razeghinejad

¹Glaucoma Service, Wills Eye Hospital, Philadelphia, PA, USA²Ophthalmology Department, Tanta Medical School, Tanta University, Tanta, Gharbia, Egypt

Abstract

Glaucoma is a chronic optic neuropathy that causes characteristic visual field defects and is considered one of the leading causes of irreversible vision loss worldwide. Lowering intraocular pressure is the only proven treatment for glaucoma. Medical therapy is usually the first-line treatment for open-angle glaucoma and ocular hypertension. Latanoprostene bunod ophthalmic drop 0.024% is a nitric oxide-donating prostaglandin F2α analog. It lowers the intraocular pressure via a dual mechanism of enhancing aqueous humor outflow through both the trabecular meshwork and uveoscleral pathways. Additionally, the nitric oxide component has shown promise in regulating ocular blood flow and promoting the survival of retinal ganglionic cells. Herein, the mechanism of action, efficacy, safety, and tolerability of the latanoprostene bunod and its effects on ocular blood flow are reviewed. Latanoprostene bunod has demonstrated strong efficacy and a favorable safety profile in both clinical trials and real-world studies. Given the promising results of latanoprostene bunod and advancements in drug delivery, topical fixed-combination and sustained-release formulations containing latanoprostene bunod and other agents targeting different intraocular pressure-lowering mechanisms may become available in the future.

摘要:青光眼是一种引起特征性视野缺损的慢性视神经病变，被认为是世界范围内不可逆视力丧失的主要原因之一。降低眼压是治疗青光眼的唯一有效方法。药物治疗通常是开角型青光眼和高眼压的一线治疗方法。0.024%拉坦前列腺素滴眼液是一氧化氮供体前列腺素F2α类似物。它通过小梁网和巩膜通路增强房水流出的双重机制降低眼压。此外，一氧化氮成分在调节眼血流和促进视网膜神经节细胞存活方面显示出前景。本文就拉坦前列腺素的作用机制、疗效、安全性、耐受性及其对眼血流的影响进行综述。在临床试验和现实世界的研究中，拉坦前列腺素已显示出强大的疗效和良好的安全性。鉴于拉坦前列腺素的前景和药物传递技术的进步，未来可能会出现含有拉坦前列腺素和其他靶向不同眼压降机制的药物的局部固定联合和缓释制剂。