288 results on '"Ripasudil"'
Search Results
52. Status of Rho kinase inhibitors in glaucoma therapeutics—an overview
- Author
-
Rakhi Kushumesh, Anita Ambasta, Bibhuti Prasanna Sinha, Rashmi Kumari, and Bhawesh Chandra Saha
- Subjects
Intraocular pressure ,genetic structures ,business.industry ,medicine.medical_treatment ,Glaucoma ,Bioinformatics ,medicine.disease ,eye diseases ,Clinical trial ,Ophthalmology ,chemistry.chemical_compound ,chemistry ,Glaucoma surgery ,medicine ,Optic nerve ,sense organs ,Ripasudil ,Bleb (medicine) ,business ,Adverse effect - Abstract
Medical management remains the cornerstone of glaucoma management despite advances in the surgical or laser procedures. After a leap of almost two decades of the advent of prostaglandin analogues, recently a new class of drug, Rho kinase (ROCK) inhibitors, has come to limelight because of their varied therapeutic potential in different clinical conditions of eye, especially glaucoma. Their efficacy of lowering intraocular pressure (IOP) by virtue of an entirely different mechanism of decreasing outflow resistance has ignited a series of clinical trials evaluating their potential as monotherapy or as adjunct to existing antiglaucoma medications, and three of them ripasudil, netarsudil and roclatan have even been approved for clinical use in the recent past. There are evidences suggesting their beneficial effects in glaucoma patients even via non-IOP-dependent mechanisms like neuroprotection by improving blood flow to the optic nerve and increasing ganglion cell survival. They can even act as antifibrotic agents and reduce bleb scarring after glaucoma surgery. Hence, their effective role in glaucomatous optic neuropathy is multifaceted primary being improved drainage through the conventional pathway. On the other hand, certain local adverse effects like conjunctival hyperaemia have been reported in substantial proportion of patients, while some others like blepharitis, subconjunctival haemorrhages and cornea verticillata constitute less common side effects. The purpose of this review is to summarize the discovery, evolution and recent update of clinical trials on Rho kinase inhibitors as antiglaucoma medicine and to delineate their role in existing management protocol.
- Published
- 2021
53. Topical Ripasudil for the Treatment of Primary Corneal Endothelial Degeneration in Dogs
- Author
-
Sarah R. Michalak, Soohyun Kim, Sangwan Park, M. Isabel Casanova, Morgan A. W. Bowman, Michelle Ferneding, Brian C. Leonard, Kathryn L. Good, Jennifer Y. Li, and Sara M. Thomasy
- Subjects
Corneal Dystrophies, Hereditary ,Sulfonamides ,Corneal Dystrophies ,Corneal Edema ,ripasudil ,Biomedical Engineering ,Evaluation of treatments and therapeutic interventions ,canine ,Fuchs endothelial corneal dystrophy ,Eye ,Isoquinolines ,Ophthalmology ,corneal endothelium ,Hereditary ,Dogs ,Opthalmology and Optometry ,6.1 Pharmaceuticals ,Rho associated kinase inhibitor ,Animals ,Humans ,Eye Disease and Disorders of Vision - Abstract
PurposeThe purpose of this study was to evaluate the tolerability and efficacy of topical rho-kinase inhibitor ripasudil in the treatment of primary corneal endothelial degeneration (PCED) in dogs.MethodsTwenty-one eyes of 12 client-owned, PCED-affected dogs received topical ripasudil 4 times daily. Ophthalmic examination, ultrasonic pachymetry (USP), Fourier-domain optical coherence tomography (FD-OCT), and in vivo confocal microscopy were performed at baseline and 1, 3, 6, and 12 months. Effects of treatment on corneal thickness, corneal edema extent, and endothelial cell density (ECD) were evaluated by repeated-measures ANOVA or Friedman test. Individual eyes were classified as improved, progressed, or stable at 12 months using clinical response criteria. Kaplan-Meier curves and log-rank test were used to compare ripasudil-treated eyes to age-, breed/size-, and disease stage-matched historical controls.ResultsDuring treatment, 12 dogs developed conjunctival hyperemia, 4 demonstrated reticular bullous epithelial edema, and 2 developed corneal stromal hemorrhage. No adverse event necessitated permanent cessation of ripasudil. Central corneal thickness measured by USP significantly progressed from baseline to 12 months. Corneal thickness by FD-OCT, ECD, and edema extent did not differ over time. Considered individually, 5 eyes improved, 8 remained stable, and 8 progressed. The log-rank test found less edema progression in ripasudil-treated eyes compared to historical controls.ConclusionsRipasudil was well-tolerated in PCED-affected dogs. Response to therapy varied; 62% of eyes showed improved or stable disease whereas 38% progressed. Ripasudil-treated eyes progressed more slowly than historical controls.Translational relevanceTopical ripasudil offered a therapeutic benefit in a subset of patients using a canine model of endothelial degeneration, which may guide future trials in humans.
- Published
- 2022
54. Recent Clinical Research on Glaucoma.
- Author
-
Garcia-Medina, Jose Javier, Garcia-Medina, Jose Javier, and Pinazo-Duran, Maria Dolores
- Subjects
Medicine ,BDNF ,BRVO ,Corvis® ST ,NTG ,OCT ,OCTA ,Schlemm's canal incision ,VEGF ,acrobatic gymnastics ,apoptosis ,aqueous outflow ,baseline intraocular pressure ,biomarker ,biomarkers ,blood flow ,central corneal thickness ,cornea biomechanics ,corneal biomechanics ,corneal hysteresis ,correlation ,crocin ,cytokines ,deep learning ,disc ,fractalkine ,function ,genes ,glaucoma ,glaucoma suspect ,hand balance ,inflammation ,inner ,intraocular pressure ,lamina cribrosa ,macula ,macular segmentation ,mfVEP ,miRNAs ,microglia ,microperimetry ,multifocal visual evoked potentials ,myopia ,n/a ,neurodegeneration ,next generation sequencing ,obesity ,ocular biomarkers ,ocular health ,ocular hypertension ,ocular inflammation ,open-angle glaucoma ,optic nerve ,optical coherence tomography angiography ,optical coherence tomography-angiography ,outer ,oxidative stress ,perimetry ,peripapillary ,peripapillary vessel density ,phenotype ,physical exercise ,polymorphism ,retina ,retinal glial cells ,ripasudil ,risk factor ,saffron ,signaling pathways ,sport ,structure ,subclinical keratoconus ,susceptibility ,suture trabeculotomy ab interno ,tears ,tumbling skills ,vascular density ,vessel density ,young adults - Abstract
Summary: In the past few years, knowledge about glaucoma diagnosis and follow up has evolved dramatically through advances in intraocular pressure (IOP) measurement, corneal biomechanics, structural and functional assessment of the ocular surface, anterior chamber, retina, optic nerve and intracranial visual pathways, as well as the advent of artificial intelligence. In addition, the development of new modalities of IOP-lowering and non-IOP-lowering drugs, alternative deliveries, refined laser technologies, and minimally invasive glaucoma surgery (MIGS) techniques with different implants have widened the therapeutic possibilities for treating this disease. Finally, current insights into risk factors and quality of life in relation to glaucomatous impairment are emerging. The purpose of this Special Issue is to present the latest exciting clinical developments that are taking place in the field of glaucoma.
55. Effectiveness and safety of switching from prostaglandin analog monotherapy to prostaglandin/timolol fixed combination therapy or adding ripasudil.
- Author
-
Inoue, Kenji, Ishida, Kyoko, and Tomita, Goji
- Subjects
- *
PROSTAGLANDINS , *TIMOLOL maleate , *GLAUCOMA , *INTRAOCULAR pressure , *COMPARATIVE studies , *PATIENTS , *THERAPEUTICS - Abstract
Purpose: To compare the effectiveness and safety of either switching from topical prostaglandin (PG) analog monotherapy to topical PG/timolol fixed combination therapy or adding topical ripasudil therapy.Study design: An open-label, prospective, randomized, parallel group, comparative studyMethods: Fifty-one patients (51 eyes) with primary open-angle glaucoma who experienced insufficient intraocular pressure (IOP) control while taking a PG analog were enrolled. The participants were divided into the following treatment groups: PG/timolol fixed combination (switched group) or ripasudil therapy addition (added group). Blood pressure, IOP, and pulse rate were measured at baseline and after 1 and 3 months of study treatment. Adverse reactions and decreased effectiveness were examined.Results: The mean IOP after 3 months of therapy was 14.3 ± 2.2 mmHg in the switched group and 14.7 ± 3.0 mmHg in the added group, both of which were significantly lower than those at baseline (switched, 16.3 ± 3.0 mmHg; added, 16.6 ± 2.8 mmHg; both P <.001). At 3 months, the IOP was reduced by 2.0 ± 1.7 mmHg (11.7 ± 9.6%) in the switched group and by 1.8 ± 2.1 mmHg (10.7 ± 12.5%) in the added group. In the added group, the diastolic blood pressure after 1 month of therapy was significantly lower than that at baseline (P <.05). In the switched group, 10 (40.0%) and 2 (8.0%) participants experienced adverse reactions at 1 and 3 months, respectively. In the added group, 6 (23.1%) and 4 (15.4%) participants experienced adverse reactions at 1 and 3 months, respectively. Treatment was discontinued in 4 participants (16.0%) in the switched group and in 1 participant (3.8%) in the added group.Conclusion: Treatment changes involving either switching from a PG analog to PG/timolol fixed combination eye drops or adding ripasudil to PG analog therapy were equally safe and effective in reducing IOP. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
56. Increase in the OCT angiographic peripapillary vessel density by ROCK inhibitor ripasudil instillation: a comparison with brimonidine.
- Author
-
Chihara, Etsuo, Dimitrova, Galina, and Chihara, Tomoyuki
- Subjects
- *
RETINAL diseases , *PROTEIN kinases , *OPTICAL coherence tomography , *VISUAL acuity , *OCULAR hypertension , *INTRAOCULAR pressure , *EYE diseases - Abstract
Purpose: To assess the responses of the superficial peripapillary retinal vessel density (VD) and prelaminar flow index (PLFI) to topical Rho-assisted coiled-coil forming protein kinase (ROCK) inhibitor ripasudil and alpha-2 agonist brimonidine using optical coherence tomography angiography.Methods: This is a prospective, non-randomized, comparative cohort study. We studied the response of optical coherence tomography angiography (OCTA) parameters to drugs in 24 eyes treated with ripasudil and 23 eyes treated with brimonidine at the Sensho-kai Eye Institute. After division by the signal strength (SS), we compared the responses of peripapillary VD/SS and PLFI/unit area (UA)/SS to topical eye drops in eyes with primary open-angle glaucoma (POAG) and ocular hypertension (OH).Results: In the superficial peripapillary retina, VD/SS increased significantly in the ripasudil-treated eyes (12.5 ± 21.7%, P = 0.018), but not in the brimonidine-treated eyes (− 2.0 ± 13.8%, P = 0.484). In the deeper area of the optic disc, the changes in the PLFI/UA/SS in the brimonidine-treated eyes (+ 0.9 ± 8.9%, P = 1.00) and ripasudil-treated eyes (− 1.3 ± 8.5%, P = 0.241) were not significant. Multivariate discriminant analysis showed that the change in the peripapillary VD/SS was the most important parameter (P = 0.0186) for differentiating ripasudil- and brimonidine-treated eyes.Conclusions: The topical ROCK inhibitor ripasudil enhanced the peripapillary VD in POAG and OH, whereas the alpha-2 agonist brimonidine did not. The PLFI did not respond to either drug. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
57. Efficacy and safety of ripasudil, a Rho-associated kinase inhibitor, in eyes with uveitic glaucoma.
- Author
-
Kusuhara, Sentaro, Katsuyama, Atsuko, Matsumiya, Wataru, and Nakamura, Makoto
- Subjects
- *
RHO-associated kinases , *GLAUCOMA treatment , *KINASE inhibitors , *DRUG efficacy , *MEDICATION safety , *THERAPEUTICS - Abstract
Purpose: The purpose of this study was to describe the initial experience, efficacy, and safety of ripasudil hydrochloride hydrate (ripasudil), a Rho-associated kinase inhibitor eye drop, for uveitic glaucoma.Methods: In this retrospective case series, we retrieved the clinical data of 21 eyes from 19 patients with open-angle uveitic glaucoma who were treated with ripasudil at Kobe University Hospital. We analyzed the median intraocular pressure (IOP) reductions after ripasudil treatment and collected the information on the adverse events that were encountered during the course of this treatment period.Results: The causes of uveitis were sarcoidosis (29%), Behçet’s disease (14%), Vogt-Koyanagi-Harada disease (10%), others (15%), and unclassified (33%). Of total, 19 (90%) eyes were treated with topical, periocular, and/or systemic steroid therapies. The median number of glaucoma medications used before ripasudil treatment was 2, and the median follow-up time was 13 months. The median IOPs were 23 mmHg at baseline, 16 mmHg at 1 month, and 18 mmHg at 12 months with significant IOP reductions of − 3 mmHg at 1 month and − 2 mmHg at 12 months (
P = 0.0050). Of total, 11 (52%) eyes with an IOP reduction ≥ 3 mmHg at 1 month (responders) showed a significant median IOP decrease at 12 months compared with non-responders (− 5 versus 0 mmHg,P = 0.0242). Two adverse events were observed: rashes on the back and transient conjunctival hyperemia.Conclusions: Ripasudil appears to be safe and substantially reduce IOP in eyes with uveitic glaucoma if the eye is a responder. Ripasudil could be an option for the treatment of uveitic glaucoma. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
58. Efficacy and safety of adding ripasudil to existing treatment regimens for reducing intraocular pressure.
- Author
-
Inoue, Kenji, Okayama, Ryoko, Shiokawa, Minako, Ishida, Kyoko, and Tomita, Goji
- Abstract
Purpose: Ripasudil accelerates aqueous humour drainage along the trabecular meshwork—Schlemm’s canal route and has been approved for clinical use in Japan. We retrospectively investigated the efficacy and safety of adding ripasudil to existing treatment regimens to reduce intraocular pressure (IOP) in patients with glaucoma.Methods: A total of 119 eyes from 119 subjects (61 men, 58 women) with primary open-angle glaucoma or ocular hypertension who had ripasudil added to their treatment regimens between December 2014 and June 2015 were included. An average of 3.8 ± 1.0 anti-glaucoma medications was in use before adding ripasudil. Subjects were divided into four groups based on the number of medications included in the original treatment regimen: ≤2, 3, 4, or ≥5 medications. The IOP was compared before and after 1 and 3 months of treatment with ripasudil for all subjects and between groups. Patients for whom ripasudil use was discontinued within 3 months were also examined.Results: The IOP was significantly lower in all patients after 1 month (17.5 ± 4.5 mmHg) and 3 months (16.8 ± 4.2 mmHg) of treatment than it was before (19.8 ± 5.3 mmHg,
p < 0.0001). All groups were equivalent in the rate and magnitude of IOP change. Ripasudil administration was discontinued in five patients (4.2%) prior to the end of the study: three were lost to follow-up and two underwent glaucoma surgery.Conclusion: Adding ripasudil to existing glaucoma treatment regimens is effective and safe in reducing IOP, regardless of the number of medications in use. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
59. Pharmaceutical treatment of primary open angle glaucoma
- Author
-
Mashael Al-Namaeh
- Subjects
medicine.medical_specialty ,Beta-adrenergic blocking agent ,genetic structures ,Open angle glaucoma ,medicine.drug_class ,business.industry ,Glaucoma ,medicine.disease ,eye diseases ,law.invention ,Optic neuropathy ,Clinical trial ,chemistry.chemical_compound ,chemistry ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Carbonic anhydrase inhibitor ,sense organs ,Ripasudil ,business - Abstract
Background: Glaucoma is a progressive, irreversible optic neuropathy that results in serious vision loss and blindness. This review aimed to summarize key concepts of primary open angle glaucoma (POAG) pharmaceutical treatment trials over the last decade. Methods: We searched PubMed/MEDLINE and clinicaltrials.gov from January 1, 2010, to August 31, 2020, using the key words “POAG” and “Ocular topical therapeutics”. This search yielded 77 and 120 papers, respectively. Results: Thirty-three records were compatible with our inclusion criteria. Pharmaceutical treatment is a common intervention in POAG for lowering IOP. Prostaglandin (PG) analogues are most commonly recommended as initial medical therapy, which are administrated either as a monotherapy or in combination with other IOP-lowering classes of medications. Alternative therapies, such as ?-blockers, ?-2 adrenergic receptor agonists, and topical carbonic anhydrase inhibitors, have been used in combination or as a monotherapy. Rho-kinase inhibitors, such as netarsudil 0.02%, AR-13324 0.02%, and ripasudil are new IOP-lowering medications. Despite IOP reduction, there is a significant number of patients with POAG that may experience disease progression, and the risk of blindness over the long term is considerable. Conclusions: Clinical trials have indicated that pharmaceutical treatment of POAG is effective and safe. In addition, the new novel Rho-kinase inhibitors have shown significant IOP reduction. The new fixed combinations have also yielded significant reductions in IOP. POAG is a cause of irreversible vision loss, if not diagnosed and treated early. The condition is likely to progress in a significant number of patients, with a considerable risk of blindness in the long-term. How to cite this article: Al-Namaeh M. Pharmaceutical treatment of primary open angle glaucoma. Med Hypothesis Discov Innov Optom. 2021 Spring; 2(1): 8-17. DOI: https://doi.org/10.51329/mehdioptometry120
- Published
- 2021
60. Potential Functional Restoration of Corneal Endothelial Cells in Fuchs Endothelial Corneal Dystrophy by ROCK Inhibitor (Ripasudil)
- Author
-
Naoki Okumura, Ursula Schlötzer-Schrehardt, Noriko Koizumi, Andreas Gießl, Friedrich E. Kruse, Mark A. Greiner, Shigeru Kinoshita, Hannah Schondorf, Matthias Zenkel, Theofilos Tourtas, Maria Strunz, Gregory A. Schmidt, and Heather da Silva
- Subjects
Male ,Endothelium ,Cell Cycle Proteins ,Cell-Matrix Junctions ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Cell Movement ,medicine ,Humans ,Cells, Cultured ,Barrier function ,Aged ,Cell Proliferation ,030304 developmental biology ,Sulfonamides ,rho-Associated Kinases ,0303 health sciences ,Dose-Response Relationship, Drug ,Chemistry ,Cell growth ,Cell Cycle ,Endothelium, Corneal ,Fuchs' Endothelial Dystrophy ,Middle Aged ,Isoquinolines ,Endothelial stem cell ,Ophthalmology ,medicine.anatomical_structure ,Descemet Stripping Endothelial Keratoplasty ,030221 ophthalmology & optometry ,Cancer research ,Female ,Ripasudil ,Wound healing ,Immortalised cell line - Abstract
Purpose Rho-associated kinase (ROCK) inhibitors have been successfully used as a rescue strategy in eyes that failed to clear after descemetorhexis without endothelial graft for treatment of Fuchs endothelial corneal dystrophy (FECD). The functional mechanisms by which ROCK inhibitors modulate corneal endothelial cell regeneration in FECD patients have, however, not been clarified. Here, we analyzed the effect of the ROCK inhibitor ripasudil on corneal endothelial cells of FECD patients and normal donors using ex vivo tissue and in vitro cellular models. Design Experimental study: laboratory investigation. Methods This institutional study used endothelial cell–Descemet membrane lamellae from FECD patients (n = 450) undergoing Descemet membrane endothelial keratoplasty (FECD ex vivo model), normal research-grade donor corneas (n = 30) after scraping off central endothelial cells (ex vivo wound healing model), normal donor corneas (n = 20) without endothelial injury, and immortalized cell lines (n = 3) generated from FECD patients (FECD in vitro model). Descemet membrane lamellae were dissected into halves and incubated for 24-72 hours in storage medium with or without a single dose of 30 μM ripasudil. The effects of ripasudil on expression of genes and proteins related to endothelial cell proliferation, migration, functionality, and endothelial-to-mesenchymal transition were analyzed and complemented by functional assays on FECD cell lines. Results A single dose of ripasudil induced significant upregulation of genes and proteins related to cell cycle progression, cell-matrix adhesion and migration, as well as endothelial barrier and pump function up to 72 hours, whereas classical markers of endothelial-to-mesenchymal transition were downregulated in both FECD and normal specimens compared to unstimulated controls ex vivo. In addition to stimulation of proliferation and migration, ripasudil-induced changes in expression of functional signature genes could be also verified in FECD cell lines in vitro. Conclusions These data support the concept that inhibition of ROCK signaling represents a potent tool in regenerative therapies in FECD patients through reactivation of cell proliferation and migration as well as restoration of endothelial pump and barrier function without inducing adverse phenotypic changes.
- Published
- 2021
61. Effect of Rho Kinase Inhibitor Ripasudil (K-115) on Isolated Porcine Retinal Arterioles
- Author
-
Tsuneaki Omae, Takayuki Kamiya, Kengo Takahashi, Seigo Nakabayashi, Akira Tanner, and Akitoshi Yoshida
- Subjects
Male ,Pharmacology ,Sulfonamides ,rho-Associated Kinases ,Swine ,Chemistry ,Retinal Vessels ,Glaucoma ,Retinal ,Isoquinolines ,medicine.disease ,Arterioles ,Ophthalmology ,chemistry.chemical_compound ,Rho kinase inhibitor ,medicine ,Animals ,Female ,Pharmacology (medical) ,Ripasudil ,Protein kinase A ,Protein Kinase Inhibitors - Abstract
Purpose: To investigate the vasorelaxation effect of ripasudil (K-115), a novel Rho-associated coiled-coil-containing protein kinase (ROCK) inhibitor, on isolated retinal arterioles. We determined ...
- Published
- 2021
62. The Use of Ripasudil Hydrochloride Hydrate in Endothelial Decompensation – A Case Series
- Author
-
Pedro Manuel Baptista, Nelson Sena, Renato Ambrósio, Fernando Faria-Correia, and Marcella Q. Salomão
- Subjects
chemistry.chemical_compound ,Chemistry ,Hydrochloride ,Anesthesia ,Decompensation ,General Medicine ,Ripasudil ,Hydrate - Published
- 2021
63. Rho-Kinase-Hemmer als neue lokale Therapieoption beim primären Offenwinkelglaukom
- Author
-
C Erb and K Konieczka
- Subjects
Gynecology ,medicine.medical_specialty ,Open angle glaucoma ,business.industry ,03 medical and health sciences ,Ophthalmology ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,030221 ophthalmology & optometry ,Medicine ,Ripasudil ,business ,030217 neurology & neurosurgery - Abstract
Im Jahr 2014 in Japan und 2017 in den USA wurden die Rho-Kinase-Hemmer als neue antiglaukomatose Substanzgruppe zugelassen und sollen nun auch in Europa eingefuhrt werden. Aus diesem aktuellen Anlass soll der gegenwartige Wissensstand zu den Rho-Kinase-Hemmern vorgestellt werden. In intensiver Recherche in PubMed wurde die relevante experimentelle und klinische Literatur zu den Rho-Kinase-Hemmern Ripasudil und Netarsudil sowie der Kombination aus Netarsudil und Latanoprost herausgesucht und fur diese Ubersicht zusammengestellt. Die augeninnendrucksenkende Wirksamkeit von Ripasudil und Netarsudil liegt im Bereich des Betablockers Timolol und dem Prostaglandinanalogon Latanoprost. In der fixen Kombination Netarsudil/Latanoprost ist die Augeninnendrucksenkung starker als die der Einzelkomponenten und erreicht in 32 % einen Zieldruckbereich von unter 15 mm Hg. Die konjunktivale Hyperamie mit 53–65 % ist die haufigste lokale Nebenwirkung. Systemische Nebenwirkungen sind sehr selten, und Kontraindikationen liegen bisher nicht vor. Rho-Kinase-Hemmer sind eine interessante Neueinfuhrung fur die Glaukomtherapie, da jede neue drucksenkende Therapie eine zusatzliche Chance darstellt, das individuell festgelegte Zieldruckniveau bei einem Glaukompatienten mit einer lokalen Therapie zu erreichen. Allerdings sind viele der mit den Rho-Kinase-Hemmern assoziierten pleiotropen Effekte bisher nur experimentell gefunden worden und bedurfen in Zukunft klinischer Bestatigung.
- Published
- 2021
64. Novel immunotherapeutic effects of topically administered ripasudil (K-115) on corneal allograft survival
- Author
-
Jaemyoung Sung, Takenori Inomata, Yuichi Okumura, Kenta Fujio, Jun Zhu, Akira Murakami, Naoko Negishi, Toshinari Funaki, Hurramhon Shokirova, Mikiko Okano, Maria Miura, and Keiichi Fujimoto
- Subjects
Graft Rejection ,Male ,0301 basic medicine ,genetic structures ,Corneal diseases ,Administration, Topical ,medicine.medical_treatment ,CD11c ,lcsh:Medicine ,Inflammation ,Pharmacology ,Article ,Cornea ,Corneal Transplantation ,Neovascularization ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Transplant immunology ,medicine ,Animals ,Transplantation, Homologous ,lcsh:Science ,Eye diseases ,Corneal transplantation ,Mice, Inbred BALB C ,Sulfonamides ,Multidisciplinary ,business.industry ,lcsh:R ,Allografts ,Isoquinolines ,eye diseases ,Mice, Inbred C57BL ,030104 developmental biology ,medicine.anatomical_structure ,chemistry ,030221 ophthalmology & optometry ,lcsh:Q ,Lymph ,Ripasudil ,sense organs ,medicine.symptom ,Wound healing ,business - Abstract
Corneal allograft survival is mediated by the variety of immunological reactions and wound healing process. Our aim was to explore the effects of topical administration of ripasudil, a selective Rho-associated coiled-coil protein kinase inhibitor, on corneal allograft survival. Ripasudil was administered to mice thrice a day after allogeneic corneal transplantation. Corneal graft survival, opacity, neovascularization, re-epithelization, immune cell infiltration, and mRNA levels of angiogenic and pro-inflammatory factors in the grafted cornea and draining lymph nodes (dLNs) were evaluated with slit-lamp microscopy, immunohistochemistry, flow cytometry, and polymerase chain reaction. Graft survival was significantly prolonged with lower graft opacity and neovascularization scores in 0.4% and 2.0% ripasudil-treated groups, and mRNA levels of angiogenic and pro-inflammatory factors in ripasudil-treated grafted corneas were reduced. Moreover, 0.4% and 2.0% ripasudil reduced CD45+-infiltrated leukocyte frequency, Cd11b and Cd11c mRNA levels, and the frequencies of mature dendritic cells, IFNγ-, and IL-17- producing CD4+T cells in the dLNs of recipients. Re-epithelization rate of the grafted cornea was significantly higher in the 0.4% and 2.0% ripasudil groups than in the control. Topically applied ripasudil prolonged graft survival by downregulating neovascularization and inflammation factors, while promoting corneal re-epithelization, suggesting that ripasudil may be useful for suppressing immunological rejection in corneal transplantation.
- Published
- 2020
65. One-year efficacy of adjunctive use of Ripasudil, a rho-kinase inhibitor, in patients with glaucoma inadequately controlled with maximum medical therapy.
- Author
-
Inazaki, Hiroshi, Kobayashi, Satoshi, Anzai, Yoko, Satoh, Hisayoshi, Sato, Shimpei, Inoue, Maiko, Yamane, Shin, and Kadonosono, Kazuaki
- Subjects
- *
INTRAOCULAR pressure , *BODY fluid pressure , *ALLERGIC conjunctivitis , *GLAUCOMA , *EYE diseases - Abstract
Purpose: The aim of this study was to evaluate the one-year efficacy, ability to lower intraocular pressure, and tolerability of ripasudil, a rho-kinase inhibitor, in patients with glaucoma inadequately controlled with maximum medical therapy. Methods: This prospective, non-comparative, interventional case-series study included 39 patients with primary open-angle glaucoma inadequately controlled with maximum medical therapy before treatment with ripasudil. Ripasudil was administered twice per day as adjunctive therapy to ongoing glaucoma treatment. The primary endpoint was the degree of intraocular pressure reduction after 12 months of treatment; the secondary endpoints were the incidence of adverse events. Results: We examined 39 eyes. The intraocular pressure reduction (given as the relative percentage of intraocular pressure reduction) from baseline was −2.6 mmHg (−15.5%; 95% confidence interval, −1.1 to −3.9 mmHg; P < 0.001) after 12 months of treatment. The adverse events were conjunctival hyperemia (all patients), blepharitis (three), allergic conjunctivitis (two), punctate keratitis (two), and ophthalmalgia (one). Conclusions: Treatment with ripasudil decreased intraocular pressure in patients with glaucoma that was poorly controlled with maximal medical therapy, and it was well-tolerated. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
66. Effects of ripasudil hydrochloride hydrate (K-115), a Rho-kinase inhibitor, on ocular blood flow and ciliary artery smooth muscle contraction in rabbits.
- Author
-
Ohta, Yusuke, Takaseki, Sanae, and Yoshitomi, Takeshi
- Subjects
- *
RHO-associated kinases , *BLOOD flow , *HYDRATES , *SMOOTH muscle , *KINASE inhibitors , *GLAUCOMA treatment , *LABORATORY rabbits - Abstract
Purpose: Ripasudil, a Rho-associated coiled-coil-containing protein kinase (ROCK) inhibitor, is a novel drug for glaucoma in Japan. ROCK inhibition not only reduces intraocular pressure (IOP) but also increases ocular blood flow. We investigated the effects of ripasudil on optic disc blood flow (ODBF) in rabbit eyes and in isolated rabbit ciliary arteries. Methods: We measured IOP by tonometry and ODBF by laser speckle flowgraphy (LSFG) in male Dutch rabbits. A single drop (20 μL) of 0.8% ripasudil was delivered to the ocular surface after topical application of phenylephrine hydrochloride to reduce the ODBF. The effects of ripasudil on isolated rabbit ciliary artery smooth muscle contractions were measured in vitro with a myograph. Results: Ripasudil inhibited the reduction of ODBF induced by phenylephrine at 30 and 120 min after instillation ( P < .05). The blood flow change was not significantly correlated with the IOP change. Ripasudil induced a concentration-dependent relaxation in isolated rabbit ciliary arteries precontracted with a high-potassium solution. This relaxation was not mediated through the endothelium-dependent activities of nitric oxide synthase, prostacyclin, or the large-conductance calcium-activated K channel as shown by the inability of specific inhibitors of these pathways to block the ripasudil-induced relaxation. Conclusions: Taken together, our results showed that ripasudil not only decreased IOP but also increased ODBF in rabbits. However, the changes in IOP were not correlated with the changes in ODBF. Ripasudil also induced a concentration-dependent relaxation of isolated rabbit ciliary arteries through a NO-independent mechanism. Further investigation of the effect of ripasudil on ODBF is needed. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
67. The Future of Glaucoma Treatment Ripasudil.
- Author
-
Ismaiel, Zafer F., Hamed, Mahmoud A. Abdel, Fawzy, Samah M., and Amer, Nada E.
- Subjects
- *
GLAUCOMA treatment , *KINASE inhibitors , *BLINDNESS , *OPTIC nerve diseases , *INTRAOCULAR pressure , *THERAPEUTICS - Abstract
Glaucoma is a leading cause for worldwide blindness and is characterized by progressive optic nerve damage. The etiology of glaucoma is unknown, but elevated intraocular pressure (IOP) and advanced age have been identified as risk factors. IOP reduction is the only known treatment for glaucoma. Recently, drugs that inhibit Rho associated protein kinase (ROCK) have been studied in animals and people for their ability to lower IOP and potentially treat POAG. ROCK inhibitors lower IOP through a trabecular mechanism and may represent a new therapeutic approach for the treatment of glaucoma. Ripasudil is the first Rho-kinase inhibitor ophthalmic solution developed for the treatment of glaucoma and ocular hypertension in Japan 2014. ROCK inhibition not only reduces intraocular pressure (IOP) but also increases ocular blood flow. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
68. Time Course of Conjunctival Hyperemia Induced by a Rho-kinase Inhibitor Anti-glaucoma Eye Drop: Ripasudil 0.4%.
- Author
-
Terao, Etsuko, Nakakura, Shunsuke, Fujisawa, Yasuko, Fujio, Yuki, Matsuya, Kanae, Kobayashi, Yui, Tabuchi, Hitoshi, Yoneda, Tsuyoshi, Fukushima, Atsuki, and Kiuchi, Yoshiaki
- Subjects
- *
EYE drops , *RHO-associated kinases , *HYPEREMIA , *GLAUCOMA treatment , *CONJUNCTIVA diseases , *KINASE inhibitors , *THERAPEUTICS - Abstract
Purpose: We investigated the detailed time course of conjunctival hyperemia induced by ripasudil 0.4%, a novel Rho-kinase inhibitor anti-glaucoma eye drop, in healthy subjects. Methods: We recruited 51 healthy subjects and administered ripasudil 0.4% in their right eye. We evaluated conjunctival hyperemia using slit lamp photography and measured the intraocular pressure (IOP) using the Icare PRO Rebound Tonometer at baseline and after 5, 15, 30, 60, 90, and 120 min. The conjunctival hyperemia score was graded by three independent observers on a scale of 0 (none) to 3 (severe). Additionally, we analyzed the “percent coverage” of conjunctival hyperemia by using an automated hyperemia analysis software program; this program provides the pixel coverage of the conjunctival vessels in the region of interest. Dunnett and Steel multiple comparison tests were used, as appropriate, for the subsequent analyses. Results: The conjunctival hyperemia score and percent coverage increased rapidly after the instillation of ripasudil 0.4%, peaking at 15 min (score: 1.83 ± 0.29 [mean ± SD]) and 5 min (11.6% ± 4.7%), respectively, and then gradually decreasing until 120 min (0.45 ± 0.22 and 4.7% ± 1.8%, respectively), when they reached a level that was not significantly different from the baseline values. The IOP decreased significantly compared to the baseline at 30, 60, and 90 min, based on the Dunnett test. Conclusion: Conjunctival hyperemia induced by ripasudil 0.4% peaks rapidly to moderate severity, but subsides relatively quickly. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
69. Descemet stripping only and ripasudil for the treatment of traumatic Descemet's membrane ruptures.
- Author
-
Fernández López E, Montolío-Marzo S, Ortega Pérez C, Catalán Gómez M, Peris Martínez C, Piá Ludeña JV, and Chan E
- Subjects
- Humans, Descemet Membrane surgery, Endothelium, Corneal surgery, Visual Acuity, Endothelial Cells, Fuchs' Endothelial Dystrophy surgery, Descemet Stripping Endothelial Keratoplasty methods
- Abstract
Purpose: Descemet´s membrane ruptures (with a discontinuation of Descemet´s membrane and double detached coiled edges) in the context of complicated anterior segment surgery have rarely been described and its management can be challenging. We report a modified Descemet stripping only (DSO) technique associated with ripasudil drops to treat these cases when other techniques fail., Methods: We describe two cases of large Descemet´s membrane detachments associated with Descemet´s ruptures after cataract surgery that did not respond to two SF
6 intracameral injections. As the detached Descemet's membrane and coiled edges might have prevented endothelial cell migration, we decided to perform a modified DSO with post-operative ripasudil drops to promote corneal clearance., Results: Both cases improved significantly in unaided and best corrected visual acuity (BCVA), corneal clearance and pachymetry, avoiding the need for an endothelial keratoplasty. Endothelial cells were observed on specular microscopy within the area of the descemetorhexis., Conclusion: DSO with ripasudil drops might be a valuable tool to recover corneal clearance and avoid endothelial keratoplasty in complex Descemet´s membrane detachments with ruptures that do not respond to other treatments.- Published
- 2023
- Full Text
- View/download PDF
70. A multicenter phase II study on the safety of rho-kinase inhibitor (ripasudil) with needling for the patients after trabeculectomy.
- Author
-
Mizuno Y, Komatsu K, Tokumo K, Okada N, Onoe H, Okumichi H, Hirooka K, Miura Y, and Kiuchi Y
- Abstract
Background: There is no established method of maintaining or reducing intra ocular pressure after the needling procedure for failing blebs post trabeculectomy. Regarding newer antihypertensive medications, ripasudil, which is a rho-associated protein kinase inhibitor ophthalmic solution, was able to prevent excessive scarring in vitro. This study aims to evaluate the safety of glaucoma patients submitted to the needling procedure and administered ripasudil for preventing scarring after the procedure. We also investigate the efficacy of ripasudil after needling for bleb failure through suppression of fibrosis to the bleb., Methods: This study is a multicenter, open-label, single-arm, phase II trial to evaluate the safety and efficacy of ripasudil in glaucoma patients after the needling procedure. Forty patients who will undergo needling at least 3 months after trabeculectomy will be recruited in Hiroshima university hospital and Hiroshima eye clinic. All the patients will instill ripasudil two times per day for three months after the needling procedure. The primary endpoint is the safety of ripasudil., Conclusions: We plan to establish the safety of ripasudil and to collect information involving the efficacy of ripasudil widely in this study., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)
- Published
- 2023
- Full Text
- View/download PDF
71. One-Year Efficacy and Safety Assessment of Ripasudil, a Rho Kinase Inhibitor, in an Addition to or Replacing Existing Treatment Regimens: A Retrospective Study
- Author
-
Kyoko Ishida, Nobuko Enomoto, Ayako Anraku, Goji Tomita, and Shun Tsukahara
- Subjects
Adult ,Male ,medicine.medical_specialty ,Intraocular pressure ,Glaucoma ,chemistry.chemical_compound ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Protein Kinase Inhibitors ,Intraocular Pressure ,Aged ,Retrospective Studies ,Aged, 80 and over ,Pharmacology ,Sulfonamides ,rho-Associated Kinases ,business.industry ,Medical record ,Retrospective cohort study ,Middle Aged ,Isoquinolines ,medicine.disease ,humanities ,Ophthalmology ,Treatment Outcome ,chemistry ,Rho kinase inhibitor ,Existing Treatment ,Female ,Ripasudil ,business - Abstract
Purpose: To evaluate efficacy and safety of ripasudil for 1 year in addition to or replacing existing treatment regimens. Methods: We retrospectively reviewed the medical records for 128 eyes of 12...
- Published
- 2020
72. Effectiveness of Ripasudil, a Rho-Associated Coiled/Coil-Containing Protein Kinase Inhibitor, in Improving Retinoschisis and Cystic-Like Foveal Cavities in Eyes with X-Linked Retinoschisis
- Author
-
Mineo Kondo, Hisashi Matsubara, Hitomi Suimon, and Masahiko Sugimoto
- Subjects
medicine.medical_specialty ,genetic structures ,medicine.drug_class ,retinoschisis ,Retinoschisis ,Case Report ,chemistry.chemical_compound ,lcsh:Ophthalmology ,Foveal ,Chart review ,Ophthalmology ,medicine ,ripasudil hydrochloride hydrate ,business.industry ,x-linked retinoschisis ,cystic-like foveal cavities ,Treatment options ,Protein kinase inhibitor ,medicine.disease ,rho-associated coiled/coil-containing protein kinase inhibitor ,eye diseases ,chemistry ,lcsh:RE1-994 ,X-linked retinoschisis ,sense organs ,Ripasudil ,business ,After treatment - Abstract
This is the first reported case of a successful resolution of cystic-like foveal cavities in eyes with X-linked juvenile retinoschisis (XLRS) treated with topical ripasudil hydrochloride hydrate, a Rho-associated coiled/coil-containing protein kinase (ROCK) inhibitor. A chart review was performed on 1 patient to collect all relevant clinical information and the optical coherence tomographic (OCT) images. A healthy 18-year-old young man presented with bilateral visual disturbances. The patient was diagnosed with XLRS from the spoke-wheel pattern around the macula, negative electroretinograms, and retinoschisis with cystic-like foveal cavities in the OCT images. Significant reductions of the retinoschisis and cystic-like cavities were observed after treatment with topical ripasudil. This is the first case of XLRS that had a resolution of cystic-like foveal cavities after topical ripasudil, a ROCK inhibitor. Since many XLRS patients have a worsening of their visual acuities due to the progressive nature of retinoschisis and cystic-like foveal cavities, topical ripasudil offers a potential treatment option.
- Published
- 2020
73. Intraocular pressure-lowering effects of ripasudil in uveitic glaucoma, exfoliation glaucoma, and steroid-induced glaucoma patients: ROCK-S, a multicentre historical cohort study
- Author
-
Akiko Futakuchi, Takeshi Morimoto, Yoko Ikeda, Hidenobu Tanihara, Toshihiro Inoue, and ROCK-S study group collaborators
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Intraocular pressure ,genetic structures ,Glaucoma ,lcsh:Medicine ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Clinical trials ,Japan ,Ophthalmology ,Uveitic glaucoma ,medicine ,Humans ,Adverse effect ,lcsh:Science ,Intraocular Pressure ,Aged ,Retrospective Studies ,Aged, 80 and over ,Sulfonamides ,rho-Associated Kinases ,Multidisciplinary ,business.industry ,lcsh:R ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Isoquinolines ,eye diseases ,030104 developmental biology ,Treatment Outcome ,chemistry ,Cohort ,030221 ophthalmology & optometry ,Female ,lcsh:Q ,Ripasudil ,sense organs ,Ophthalmic Solutions ,business ,Historical Cohort - Abstract
To evaluate the efficacy and safety of ripasudil for treatment of secondary glaucoma, a historical cohort study was conducted at 18 centres in Japan. Adults (age ≥20 years) who needed additional IOP reduction and received topical 0.4% ripasudil between 2014 and 2018 due to three secondary glaucoma subtypes, including uveitic glaucoma (UG), exfoliation glaucoma (EG) or steroid-induced glaucoma (SG) were assessed for mean IOP change from baseline prior to additional treatment with ripasudil. We further evaluated the IOP change in each glaucoma subtype, baseline characteristics of each cohort, course of uveitis-induced inflammation in UG eyes, and proportion of patients in each cohort with adverse events. In 332 eyes from 332 patients eligible for this study, the mean overall IOP reductions from baseline at 1, 3, and 6 months were −5.86 ± 9.04 mmHg (−19.4 ± 25.1%), −6.18 ± 9.03 mmHg (−20.0 ± 27.1%), and −7.00 ± 8.60 mmHg (−23.4 ± 25.6%), respectively. These changes were all statistically significant. Of 332 eyes, 109 eyes had UG, 181 had EG, and 42 eyes had SG. The IOP-lowering effects of ripasudil in UG and SG were significantly greater than those of EG at every time point. This finding could have been related to higher baseline IOP levels in UG and SG. UG patients exhibited significant decreases in mean cell score of the anterior segment after ripasudil treatment. No severe adverse events were reported. These findings suggest that treatment with ripasudil is a safe and effective therapeutic modality for IOP reduction in secondary glaucoma.
- Published
- 2020
74. Safety and Efficacy of Long-Term Ripasudil 0.4% Instillation for the Reduction of Intraocular Pressure in Japanese Open-Angle Glaucoma Patients
- Author
-
Yoko Ikeda, Chie Sotozono, Morio Ueno, Yuko Maruyama, Shigeru Kinoshita, Kengo Yoshii, and Kazuhiko Mori
- Subjects
Male ,0301 basic medicine ,Intraocular pressure ,medicine.medical_specialty ,genetic structures ,Open angle glaucoma ,medicine.medical_treatment ,Glaucoma ,Hyperemia ,Conjunctival Diseases ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Japan ,Ophthalmology ,medicine ,Humans ,Pharmacology (medical) ,Intraocular Pressure ,Reduction (orthopedic surgery) ,Aged ,Retrospective Studies ,Pharmacology ,Blepharitis ,Sulfonamides ,rho-Associated Kinases ,business.industry ,Middle Aged ,Isoquinolines ,medicine.disease ,eye diseases ,Treatment Outcome ,030104 developmental biology ,chemistry ,030221 ophthalmology & optometry ,Female ,sense organs ,Ripasudil ,Ophthalmic Solutions ,Safety ,business ,Glaucoma, Open-Angle - Abstract
Purpose: Rho-associated kinase-inhibitor ripasudil 0.4% eye drops are reportedly effective for the reduction of intraocular pressure (IOP) in glaucoma patients. However, the previous studies invest...
- Published
- 2020
75. Ripasudil Hydrochloride Hydrate in the Treatment of Glaucoma: Safety, Efficacy, and Patient Selection
- Author
-
Makoto Nakamura and Sentaro Kusuhara
- Subjects
Intraocular pressure ,medicine.medical_specialty ,genetic structures ,Combination therapy ,business.industry ,Glaucoma ,medicine.disease ,eye diseases ,Allergic conjunctivitis ,03 medical and health sciences ,Ophthalmology ,chemistry.chemical_compound ,0302 clinical medicine ,medicine.anatomical_structure ,chemistry ,030221 ophthalmology & optometry ,medicine ,sense organs ,Ripasudil ,Trabecular meshwork ,Blepharitis ,business ,030217 neurology & neurosurgery ,Adverse drug reaction - Abstract
Reduction of intraocular pressure (IOP) is the only reliable treatment for glaucoma that maintains the patient's visual function throughout life, and IOP-lowering eyedrops are the mainstay of therapy. Ripasudil hydrochloride hydrate (brand name: Glanatec ophthalmic solution 0.4%; Kowa Company, Ltd., Japan) is a Rho-associated coiled -coil -containing protein kinase (ROCK) inhibitor that lowers IOP by increasing conventional aqueous outflow. Since the approval of ripasudil eyedrops in 2014, a large store of clinical data has been amassed in Japan. With regard to safety, conjunctival hyperemia is the most common adverse drug reaction (ADR) and is usually transient and mild. Blepharitis and allergic conjunctivitis are other major local ADRs. Systemic ADRs are rare, but we should be wary of allergic reactions. With regard to efficacy, ripasudil is expected to lower IOP in almost all glaucoma subtypes (including primary open-angle glaucoma, secondary glaucoma, and primary angle-closure glaucoma) and in all patterns of treatment initiation (monotherapy, combination therapy, switching therapy, and add-on therapy). However, the status of the trabecular meshwork may affect the IOP-lowering effect of ripasudil. In patient selection, current evidence-based information on the safety and efficacy of ripasudil should be fully considered. As irreversible damage to the trabecular meshwork would considerably affect efficacy, it may be better to start ripasudil treatment during an early stage of glaucoma.
- Published
- 2020
76. Morphological change and recovery of corneal endothelial cells after rho-associated protein kinase inhibitor eye-drop (ripasudil 0.4%) instillation
- Author
-
Yoko Ikeda, Morio Ueno, Chie Sotozono, Shigeru Kinoshita, Haruna Yoshikawa, Yuko Maruyama, Kengo Yoshii, and Kazuhiko Mori
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Glaucoma ,Administration, Ophthalmic ,Cell Count ,Cellular and Molecular Neuroscience ,chemistry.chemical_compound ,Ophthalmology ,Cornea ,medicine ,Humans ,In patient ,Enzyme Inhibitors ,Rho-associated protein kinase ,Intraocular Pressure ,Aged ,Retrospective Studies ,Aged, 80 and over ,Sulfonamides ,rho-Associated Kinases ,business.industry ,Endothelium, Corneal ,Eye drop ,Recovery of Function ,Middle Aged ,Isoquinolines ,medicine.disease ,Sensory Systems ,medicine.anatomical_structure ,chemistry ,SPECULAR MICROSCOPY ,Female ,Ocular Hypertension ,Corneal endothelial cell ,sense organs ,Ripasudil ,Ophthalmic Solutions ,business ,Glaucoma, Open-Angle - Abstract
Background/AimsTo investigate the time-dependent change of corneal endothelial cell (CEC) morphology and density (CECD) in patients with glaucoma post instillation of rho-associated protein kinase inhibitor ripasudil (Rip) 0.4% eye drops.MethodsThis observational study involved 163 eyes of 163 patients with glaucoma in whom CEC morphological change was evaluated by CECD calculated via non-contact specular microscopy (NCSM) before and at 1 or 3 months post-Rip instillation. The change of CECD was plotted along with elapsed time from last instillation of Rip. The patients were divided into the following three groups based on the elapsed time post-Rip instillation: Early Group (ResultsMorphological changes in the CECs appeared within 1 hour and recovered to normal within 6 hours post instillation. In the Early, Middle and Late Group, the median rate of CECD change as calculated by the NCSM automated software was −5.68%, −4.95% and −0.07%, respectively. The CEC images showed the same morphological changes with observational study in all four cases.ConclusionDue to transient morphological changes, the NCSM software produced misleading data for determining CECD within 1 hour post-Rip instillation, yet revealed that CEC morphology gradually recovered to normal within 6 hours.
- Published
- 2020
77. POTENSI RIPASUDIL SEBAGAI TERAPI TERBARUKAN UNTUK MENGATASI UVEITIS GLAUCOMA MELALUI INHIBISI RHO KINASE PATHWAY (ROCK)
- Author
-
Ilham Dhiya, Khartika Mahardini, and Iskandar Purba G
- Subjects
Intraocular pressure ,medicine.medical_specialty ,genetic structures ,business.industry ,General Engineering ,Glaucoma ,Disease ,medicine.disease ,Proinflammatory cytokine ,Clinical trial ,chemistry.chemical_compound ,chemistry ,Ophthalmology ,medicine ,General Earth and Planetary Sciences ,Ripasudil ,Risk factor ,business ,Uveitis ,General Environmental Science - Abstract
Uveitis is an inflammatory disease that accounts for 300 thousand new cases of blindness each year in America, and is responsible for 5-10% of vision changes worldwide. First-line therapy for uveitis is topical corticosteroids. Unfortunately, corticosteroid use is a risk factor for glaucoma. About 20-40% of patients experience an increase in pathological intra-ocular pressure that requires secondary glaucoma therapy. To reduce this pressure, the first therapy is beta-blockers and adrenergic agonists. But in inflammatory conditions, therapeutic side effects decrease. Over the years, a new glaucoma therapy agent, Ripasudil, has emerged. Research shows that Ripasudil can not only reduce intraocular pressure in glaucoma, but also has the anti-inflammatory effect needed to treat uveitis. The study of the potential of Ripasudil using literature obtained from the database publications of the journal Pubmed, Clinical Trials and Science Direct. Supporting articles are sought based on specific keywords by the inclusion criteria of articles won in the UK, publications of the past 10 years (except basic science), EBM articles level 1-3 and support the discussion of literature review. Ripasudil can release inflammatory cell infiltration and exudation proteins in aqueous humor. In addition, MCPI-1 protein levels and IL-1, IL-6, TNF-dan, and MCP-1 mRNA levels in the iris-ciliary body decreased after Ripasudil administration. Clinical trials also show that Ripasudil can be used as a glaucoma therapy agent. Ripasudil can be an updated therapy to treat glaucoma uveitis through inhibition of the ROCK pathway and treatment of proinflammatory mediators.
- Published
- 2019
78. STUDY ON EFFICACY AND SAFETY OF RIPASUDIL HYDROCHLORIDE IN TREATMENT OF NEWLY DIAGNOSED PRIMARY OPEN ANGLE GLAUCOMA
- Author
-
Debalina Ghanta, Sudeshna Roy, and Taneema Samanta
- Subjects
0301 basic medicine ,medicine.medical_specialty ,genetic structures ,Open angle glaucoma ,business.industry ,Hydrochloride ,Newly diagnosed ,eye diseases ,03 medical and health sciences ,chemistry.chemical_compound ,030104 developmental biology ,0302 clinical medicine ,chemistry ,Ophthalmology ,030221 ophthalmology & optometry ,medicine ,sense organs ,Ripasudil ,business - Abstract
Aim: The study aims at evaluating the lowering effect of Intraocular pressure (IOP) and tolerability of Ripasudil(0.4%) ophthalmic solution, a selective rho kinase1 inhibitor, as monotherapy in newly diagnosed primary open angle glaucoma patients. Background: Glaucoma is a chronic progressive optic neuropathy causing irreversible blindness around the world. Current treatment strategy stems from concept of lowering IOP, which is a key modiable risk factor. Ripasudil also known as K 115,is the world's rst Rho-associated coiled-coil-containing protein Kinase 1(ROCK1) inhibitor that lowers IOP by directly acting on trabecular meshwork,increasing conventional outow. Methods: This prospective, interventional study included 53 patients of newly diagnosed primary open angle glaucoma.0.4% Ripasudil ophthalmic solution was instilled twice a day as the primary treatment. The primary endpoint was the degree of IOPreduction after 6 months of treatment, whereas the secondary end points were percentage of patients reaching the predened target IOP and incidence of adverse effects. Results: We examined 53 eyes of 53 primary open angle glaucoma patients. The IOP reduction (relative percentage IOP reduction)from baseline was -2.3 mm Hg(-1.7 to -2.9 mm Hg,95%condence interval ,P
- Published
- 2021
79. Pan-ROCK and ROCK2 Inhibitors Affect Dexamethasone-Treated 2D- and 3D-Cultured Human Trabecular Meshwork (HTM) Cells in Opposite Manners
- Author
-
Hiroshi Ohguro, Yosuke Ida, Megumi Watanabe, Masato Furuhashi, Fumihito Hikage, and Yuri Tsugeno
- Subjects
endocrine system ,Cell Culture Techniques ,ripasudil ,Pharmaceutical Science ,human trabecular meshwork (HTM) ,dexamethasone ,Rho-associated coiled-coil containing protein kinase (ROCK) ,Article ,Analytical Chemistry ,Extracellular matrix ,chemistry.chemical_compound ,QD241-441 ,Trabecular Meshwork ,Drug Discovery ,medicine ,Humans ,ROCK2 ,Physical and Theoretical Chemistry ,Protein Kinase Inhibitors ,Dexamethasone ,Cells, Cultured ,Extracellular Matrix Proteins ,rho-Associated Kinases ,Chemistry ,Organic Chemistry ,Spheroid ,Cell biology ,Extracellular Matrix ,medicine.anatomical_structure ,Chemistry (miscellaneous) ,Cell culture ,Permeability (electromagnetism) ,3D spheroid cultures ,Molecular Medicine ,Trabecular meshwork ,Ripasudil ,sense organs ,Biomarkers ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug ,KD025 - Abstract
Effects of a pan-ROCK-inhibitor, ripasudil (Rip), and a ROCK2 inhibitor, KD025 on dexamethasone (DEX)-treated human trabecular meshwork (HTM) cells as a model of steroid-induced glaucoma were investigated. In the presence of Rip or KD025, DEX-treated HTM cells were subjected to permeability analysis of 2D monolayer by transendothelial electrical resistance (TEER) and FITC–dextran permeability, physical properties, size and stiffness analysis (3D), and qPCR of extracellular matrix (ECM), and their modulators. DEX resulted in a significant increase in the permeability, as well as a large and stiff 3D spheroid, and those effects were inhibited by Rip. In contrast, KD025 exerted opposite effects on the physical properties (down-sizing and softening). Furthermore, DEX induced several changes of gene expressions of ECM and their modulators were also modulated differently by Rip and KD025. The present findings indicate that Rip and KD025 induced opposite effects toward 2D and 3D cell cultures of DEX-treated HTM cells.
- Published
- 2021
- Full Text
- View/download PDF
80. Additive Intraocular Pressure Lowering Effects of the Rho Kinase Inhibitor, Ripasudil in Glaucoma Patients Not Able to Obtain Adequate Control After Other Maximal Tolerated Medical Therapy.
- Author
-
Sato, Shino, Hirooka, Kazuyuki, Nitta, Eri, Ukegawa, Kaori, and Tsujikawa, Akitaka
- Subjects
GLAUCOMA diagnosis ,COMBINATION drug therapy ,DRUG monitoring ,DRUG dosage ,DRUG toxicity ,GLAUCOMA ,ANTIHYPERTENSIVE agents ,INTRAOCULAR pressure ,ISOQUINOLINE ,PHOSPHOTRANSFERASES ,SULFONAMIDES ,TONOMETRY ,TREATMENT effectiveness ,RETROSPECTIVE studies ,CHEMICAL inhibitors - Abstract
Introduction: The aim of this study is to investigate the additive intraocular pressure (IOP)-lowering effects and safety of the selective Rho kinase inhibitor, 0.4% ripasudil, in patients with glaucoma not adequately controlled by other maximal tolerated medical therapies.Methods: We retrospectively reviewed 92 glaucoma patients who received ripasudil as an additive glaucoma treatment. In spite of receiving prior maximal tolerated medical therapies, all patients had uncontrolled glaucoma before receiving ripasudil. IOP was recorded at all follow-up dates.Results: The study population consisted of 43 primary open-angle glaucoma (POAG), 28 normal-tension glaucoma (NTG), ten secondary glaucoma, seven exfoliation glaucoma, and four developmental glaucoma patients. After ripasudil administration, there was a significant decrease in the IOP. The mean pre-administration IOP and % IOP reduction at the last follow-up were 19.7 ± 4.9 mmHg and 6.5 ± 17.0% for POAG, 15.5 ± 2.0 mmHg and 2.3 ± 10.4% for NTG, 22.8 ± 8.3 mmHg and 19.1 ± 13.5% for secondary glaucoma, 22.5 ± 4.4 mmHg and 2.1 ± 14.5% for exfoliation glaucoma, and 20.2 ± 8.9 mmHg and 11.4 ± 23.1% for developmental glaucoma, respectively. Side effects led to ripasudil discontinuation in 13 patients, with five exhibiting an allergic reaction, six developing blepharitis, and two having a burning sensation.Conclusions: Use of ripasudil as an adjunctive therapy resulted in lowering of the IOP. Ripasudil was well tolerated.Funding: Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (26462689). [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
81. One-year clinical evaluation of 0.4% ripasudil (K-115) in patients with open-angle glaucoma and ocular hypertension.
- Author
-
Tanihara, Hidenobu, Inoue, Toshihiro, Yamamoto, Tetsuya, Kuwayama, Yasuaki, Abe, Haruki, Fukushima, Atsuki, Suganami, Hideki, Araie, Makoto, Uchino, Miki, Iwasaki, Miki, Ono, Koichi, Sekiyama, Eiichi, Takahashi, Yoshinori, Fujie, Keiko, Shin, Hideyo, Kaneko, Taku, Shiba, Hiroharu, Ijuin, Nobuo, Tani, Emiko, and Manabe, Yoichi
- Subjects
- *
GLAUCOMA treatment , *INTRAOCULAR pressure , *OCULAR hypertension , *KINASE inhibitors , *TREATMENT of eye diseases , *THERAPEUTICS - Abstract
Purpose To investigate the intra-ocular pressure ( IOP)-lowering effects and safety of 0.4% ripasudil (K-115), a Rho kinase inhibitor, twice daily for 52 weeks, in patients with open-angle glaucoma or ocular hypertension ( OHT). Methods In this multicentre, prospective, open-label study, 388 patients with primary open-angle glaucoma, OHT or exfoliation glaucoma were enrolled and 354 of them were subdivided into four cohorts (monotherapy, 173; additive therapy to prostaglandin analogs, 62; β-blockers, 60; or fixed combination drugs, 59). The IOP reduction at trough and peak from baseline and adverse events was investigated. Results Ripasudil showed IOP-lowering effects over 52 weeks in all the analyses of monotherapy, additive therapy and both subgroups (baseline IOP ≥21 mmHg and <21 mmHg) of monotherapy. The mean IOP reductions at trough and peak at week 52 were −2.6 and −3.7 mmHg for monotherapy, and −1.4 and −2.4, −2.2 and −3.0, and −1.7 and −1.7 mmHg, respectively, for additive therapy described above. The most frequently observed adverse events were conjunctival hyperaemia ( n = 264, 74.6%), blepharitis ( n = 73, 20.6%) and allergic conjunctivitis ( n = 61, 17.2%). Most of the conjunctival hyperaemia findings were mild (97.0%), transient and resolved spontaneously (78.0%). Although 51 patients discontinued from the study due to blepharitis and/or allergic conjunctivitis (blepharitis, 28; allergic conjunctivitis, 17; both, 6), all the events resolved with or without treatment after the discontinuation of ripasudil administration. Conclusion Fifty-two week administration of 0.4% ripasudil revealed IOP-lowering effects and an acceptable safety profile when administered as monotherapy or as additive therapy, in patients with open-angle glaucoma or OHT. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
82. Rho-Kinase Inhibitors for the Treatment of Refractory Diabetic Macular Oedema
- Author
-
Ricardo Usategui-Martín, Luis García-Onrubia, Milagros Mateos-Olivares, J. Carlos Pastor, Rogelio González-Sarmiento, Maribel Lopez-Galvez, Fco. Javier Valentín-Bravo, and Salvador Pastor-Idoate
- Subjects
0301 basic medicine ,genetic structures ,QH301-705.5 ,Diabetic macular oedema ,Review ,Diabetes - Complicaciones y secuelas ,Bioinformatics ,Macular Edema ,Retina ,Pathogenesis ,Translational Research, Biomedical ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Refractory ,Protein kinases ,Diabetic retinopathy ,medicine ,Animals ,Humans ,Biology (General) ,Rho-associated protein kinase ,Macular edema ,Protein Kinase Inhibitors ,macular oedema ,business.industry ,rho-associated kinases ,Fasudil ,General Medicine ,Ojos - Enfermedades ,medicine.disease ,Retina - Enfermedades ,diabetic retinopathy ,030104 developmental biology ,chemistry ,diabetic macular oedema ,3201.09 Oftalmología ,030221 ophthalmology & optometry ,Macular oedema ,Ripasudil ,business ,Signal Transduction - Abstract
Producción Científica, Diabetic macular oedema (DMO) is one of the leading causes of vision loss associated with diabetic retinopathy (DR). New insights in managing this condition have changed the paradigm in its treatment, with intravitreal injections of antivascular endothelial growth factor (anti-VEGF) having become the standard therapy for DMO worldwide. However, there is no single standard therapy for all patients DMO refractory to anti-VEGF treatment; thus, further investigation is still needed. The key obstacles in developing suitable therapeutics for refractory DMO lie in its complex pathophysiology; therefore, there is an opportunity for further improvements in the progress and applications of new drugs. Previous studies have indicated that Rho-associated kinase (Rho-kinase/ROCK) is an essential molecule in the pathogenesis of DMO. This is why the Rho/ROCK signalling pathway has been proposed as a possible target for new treatments. The present review focuses on the recent progress on the possible role of ROCK and its therapeutic potential in DMO. A systematic literature search was performed, covering the years 1991 to 2021, using the following keywords: “rho-Associated Kinas-es”, “Diabetic Retinopathy”, “Macular Edema”, “Ripasudil”, “Fasudil” and “Netarsudil”. Better insight into the pathological role of Rho-kinase/ROCK may lead to the development of new strategies for refractory DMO treatment and prevention.
- Published
- 2021
83. Rosiglitasone and ROCK Inhibitors Modulate Fibrogenetic Changes in TGF-β2 Treated Human Conjunctival Fibroblasts (HconF) in Different Manners
- Author
-
Yosuke Ida, Fumihito Hikage, Yuika Oouchi, Hiroshi Ohguro, and Megumi Watanabe
- Subjects
0301 basic medicine ,3D culture ,QH301-705.5 ,ripasudil ,Catalysis ,Article ,ROCK inhibitor ,Cell Line ,Inorganic Chemistry ,Extracellular matrix ,Rosiglitazone ,03 medical and health sciences ,Transforming Growth Factor beta2 ,0302 clinical medicine ,human conjunctival fibroblast ,Organoid ,Humans ,ROCK2 ,Physical and Theoretical Chemistry ,Biology (General) ,Protein kinase A ,Molecular Biology ,Rho-associated protein kinase ,QD1-999 ,Spectroscopy ,rho-Associated Kinases ,biology ,Chemistry ,TGFβ2 ,Organic Chemistry ,General Medicine ,Fibroblasts ,Molecular biology ,Actins ,Computer Science Applications ,Fibronectins ,Fibronectin ,030104 developmental biology ,Real-time polymerase chain reaction ,Gene Expression Regulation ,030221 ophthalmology & optometry ,biology.protein ,Collagen ,Conjunctiva ,Transforming growth factor ,KD025 - Abstract
Purpose: The effects of Rho-associated coiled-coil containing protein kinase (ROCK) 1 and 2 inhibitor, ripasudil hydrochloride hydrate (Rip), ROCK2 inhibitor, KD025 or rosiglitazone (Rosi) on two-dimension (2D) and three-dimension (3D) cultured human conjunctival fibroblasts (HconF) treated by transforming growth factor (TGFβ2) were studied. Methods: Two-dimension and three-dimension cultured HconF were examined by transendothelial electrical resistance (TEER, 2D), size and stiffness (3D), and the expression of the extracellular matrix (ECM) including collagen1 (COL1), COL4 and COL6, fibronectin (FN), and α-smooth muscle actin (αSMA) by quantitative PCR (2D, 3D) in the presence of Rip, KD025 or Rosi. Results: TGFβ2 caused a significant increase in (1) the TEER values (2D) which were greatly reduced by Rosi, (2) the stiffness of the 3D organoids which were substantially reduced by Rip or KD025, and (3) TGFβ2 induced a significant up-regulation of all ECMs, except for COL6 (2D) or αSMA (3D), and down-regulation of COL6 (2D). Rosi caused a significant up-regulation of COL1, 4 and 6 (3D), and down-regulation of COL6 (2D) and αSMA (3D). Most of these TGFβ2-induced expressions in the 2D and αSMA in the 3D were substantially inhibited by KD025, but COL4 and αSMA in 2D were further enhanced by Rip. Conclusion: The findings reported herein indicate that TGFβ2 induces an increase in fibrogenetic changes on the plane and in the spatial space, and are inhibited by Rosi and ROCK inhibitors, respectively.
- Published
- 2021
84. Ripasudil Endgame: Role of Rho-Kinase Inhibitor as a Last-Ditch-Stand Towards Maximally Tolerated Medical Therapy to a Patient of Advanced Glaucoma
- Author
-
Kartikeya Srivastava, HarinderSingh Sethi, Mayuresh Naik, Monika Kapur, and VishnuSwarup Gupta
- Subjects
medicine.medical_specialty ,Intraocular pressure ,Open angle glaucoma ,genetic structures ,Glaucoma ,chemistry.chemical_compound ,Ophthalmology ,medicine ,In patient ,Original Research ,business.industry ,advanced glaucoma ,Clinical Ophthalmology ,medicine.disease ,maximally-tolerated-medical-therapy ,eye diseases ,Safety profile ,chemistry ,COVID-19 lockdown ,Rho kinase inhibitor ,ripausdil ,Ripasudil ,sense organs ,business ,Medical therapy ,ROCK1 inhibitor - Abstract
Mayuresh Naik,1 Monika Kapur,2 VishnuSwarup Gupta,1 HarinderSingh Sethi,3 Kartikeya Srivastava3 1Department of Ophthalmology, H.I.M.S.R & H.A.H. Centenary Hospital, New Delhi, India; 2Department of Ophthalmology, School of Medical Sciences & Research, Sharda University, Greater Noid, Uttar Pradesh, India; 3Department of Ophthalmology, V.M.M.C & Safdarjung Hospital, New Delhi, 110029, IndiaCorrespondence: Mayuresh NaikDepartment of Ophthalmology, H.I.M.S.R & H.A.H. Centenary Hospital, Room No. 3 of Eye OPD, 1st Floor of OPD Building, Near GK-2, Alaknanda, New Delhi, 110062, IndiaTel +91-8287344576Email mayureshpnaik@gmail.comPurpose: To elucidate the use of Ripasudil in patients of advanced glaucoma on maximally tolerated medical therapy who could not be offered the option of surgery due to the global pandemic lockdown.Materials and Methods: Only patients with primary open angle glaucoma (POAG), who had a cup-disc ratio (CDR) of 0.9 or a near total cupping on maximum tolerated medical therapy for at least 4 weeks and yet could not meet the target IOP were included. Target IOP was defined as ⤠12 mm Hg. A total of 30 patients were enrolled. All patients in study cohort were started on E/D Ripasudil BD. Patients were followed up at 1 week, 2 weeks, 4 weeks and then monthly for 6 months for their best corrected visual acuity (BCVA), intraocular pressure (IOP), disc changes (slit lamp biomicroscopy), perimetry, and retinal nerve fibre layer analysis using optical coherence tomography (OCT-RNFL).Results: Mean pre-treatment IOP on five drugs was 18.3 ± 2.1 mm Hg (range 14 to 22mmHg) on maximally tolerated medical therapy. At 1 week follow-up, mean post-treatment IOP was 15.1 ± 1.7 mm Hg (range 12 to 18mmHg) and at 2 week follow-up, mean post-treatment IOP was 12.5 ± 1.9 mmHg (range 10 to 16mmHg). Thus, target IOP ⤠12mmHg was attained in 28 patients at 2 weeks. This target IOP was maintained throughout the 6 months of follow-up period. Of the 2 patients who could not meet target IOP, 1 patient needed rearrangement of their fixed-drug-combinations to achieve target IOP at 4 weeks. The second patient required unfixing of all fixed-drug-combinations to achieve target IOP at maximally tolerated medical therapy at 6 weeks.Conclusion: Ripasudil not only provides a better IOP control but also has a high safety profile even when started as an add-on drug to already-existing yet inadequate maximally tolerated medical therapy.Keywords: advanced glaucoma, ripausdil, ROCK1 inhibitor, maximally-tolerated-medical-therapy, COVID-19 lockdown
- Published
- 2021
85. Changes in corneal endothelial cell shape after treatment with one drop of ROCK inhibitor
- Author
-
Goji Tomita, Hidenobu Tanihara, Minako Shiokawa, Madoka Ono, Riyo Matsumura, Kenji Inoue, and Kyoko Ishida
- Subjects
Adult ,Male ,Intraocular pressure ,medicine.medical_specialty ,genetic structures ,Hexagonal cell ,Slit Lamp Microscopy ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Conjunctival hyperemia ,Rho-associated protein kinase ,Clinical treatment ,Intraocular Pressure ,Sulfonamides ,business.industry ,Endothelium, Corneal ,Glaucoma ,Middle Aged ,Isoquinolines ,Healthy Volunteers ,eye diseases ,chemistry ,cardiovascular system ,030221 ophthalmology & optometry ,Female ,Corneal endothelial cell ,sense organs ,Ripasudil ,Ophthalmic Solutions ,business ,030217 neurology & neurosurgery ,After treatment - Abstract
We performed an investigation of the temporal impact on corneal endothelial cell (CEC) shape after ophthalmic instillation of one drop of the ROCK inhibitor, ripasudil. Subjects comprised 32 healthy adult volunteers, each of whom instilled ripasudil in the right eye. CEC shape [defined as CEC density (CECD), coefficient of variation (CV), and hexagonal cell rate (6A)], central corneal thickness (CCT), intraocular pressure (IOP), and conjunctival hyperemia were evaluated before instillation (baseline) and at 15 min, 1 h, 2 h, and 4–6 h after instillation by non-contact specular microscopy and slit-lamp microscopy. The incidence of pseudo gutta was also assessed. The CECD (cells/mm2) significantly decreased after instillation as follows: 2661 cells/mm2 at baseline, 2578 cells/mm2 at 15 min, 2527 cells/mm2 at 1 h, 2575 cells/mm2 at 2 h, and 2613 cells/mm2 at 4–6 h. After instillation, CV significantly increased and 6A significantly decreased. Pseudo gutta appeared in 18 subjects (56.3%) after instillation. There was no difference in CCT before and after instillation. IOP significantly decreased after instillation. The most severe conjunctival hyperemia was observed at 15 min after instillation, but had nearly disappeared within 2 h. Pseudo gutta appeared in more than half of the subjects, and the CEC shape changed upon instillation of one drop of ripasudil; however, it recovered at 4–6 h after instillation. Therefore, these changes would not greatly impact clinical treatment. Similar to the presence of conjunctival hyperemia, changes in CEC shape occur at early stages after instillation of ripasudil.
- Published
- 2019
86. Rho-kinase inhibitors in the management of glaucoma
- Author
-
Emanuela Berrino and Claudiu T. Supuran
- Subjects
Intraocular pressure ,genetic structures ,Glaucoma ,Aqueous humor ,Bioinformatics ,01 natural sciences ,Patents as Topic ,03 medical and health sciences ,chemistry.chemical_compound ,Elevated intraocular pressure ,0302 clinical medicine ,Drug Development ,Drug Discovery ,medicine ,Animals ,Humans ,Protein Kinase Inhibitors ,Rho-associated protein kinase ,Intraocular Pressure ,Pharmacology ,rho-Associated Kinases ,business.industry ,General Medicine ,medicine.disease ,eye diseases ,0104 chemical sciences ,010404 medicinal & biomolecular chemistry ,medicine.anatomical_structure ,chemistry ,Drug development ,030220 oncology & carcinogenesis ,Disease Progression ,sense organs ,Ripasudil ,Trabecular meshwork ,business - Abstract
Introduction: Glaucoma is a group of progressive optic neuropathies in which elevated intraocular pressure (IOP) as a consequence of an increased aqueous humor (AH) outflow resistance, is the main and only clinically modifiable risk factor for its development and progression. Relaxing Trabecular meshwork (TM) tissue, Rho-Kinase (ROCK) inhibitors directly decrease resistance in the conventional AH outflow, thus resulting in a significant IOP-lowering effect. Areas covered: The progress made in the field of ROCK inhibitors for glaucoma treatment will be discussed, referring to the recent patent literature published mainly in the last 3 years. Development and last studies conducted on the recently approved ripasudil and netarsudil will be described, along with newly reported combinations with other antiglaucoma agents. New molecular entities as ROCK inhibitors will be reported as well as new biological approaches to affect the Rho/ROCK pathway. Expert opinion: With three drugs currently available on the market belonging to this class, ROCK inhibitors have been definitely validated as therapeutic agents for glaucoma treatment. The literature of the last 3 years confirmed the success of the soft-drug and bis-functional approaches in the design of ROCK inhibitors. However, few completely new molecular scaffolds have been reported.
- Published
- 2019
87. Effects of 0.4% ripasudil hydrochloride hydrate on morphological changes in rabbit eyes
- Author
-
Shigekazu Uga, Bundit Limratchatamorn, Kimiyo Mashimo, Ken Asakawa, and Hitoshi Ishikawa
- Subjects
Intraocular pressure ,medicine.medical_specialty ,genetic structures ,actin filament ,side effect ,Hydrochloride ,biology.animal_breed ,rabbit ,Dutch rabbit ,law.invention ,chemistry.chemical_compound ,Ciliary body ,lcsh:Ophthalmology ,law ,Ophthalmology ,Medicine ,ripasudil hydrochloride hydrate ,biology ,business.industry ,Brief Report ,medicine.anatomical_structure ,chemistry ,lcsh:RE1-994 ,Ripasudil ,Trabecular meshwork ,sense organs ,Electron microscope ,business ,Hydrate - Abstract
We evaluated the cellular structure changes after continuous use of ripasudil hydrochloride hydrate in rabbit eyes which might affect its own efficacy and adverse effects. Two pigmented Dutch rabbits and 1 Japanese white rabbit were instilled with 0.4% ripasudil hydrochloride hydrate to the left eye twice daily. The right eye was observed as the control. Both eyes of all 3 rabbits were then enucleated for histopathologic examination by light and electron microscope at 1mo in 1 of the pigmented Dutch rabbits, 3mo in the other pigmented Dutch rabbit, and in the Japanese white rabbit after instillation. Microscopic observations showed increase intercellular space in trabecular meshwork, ciliary body, and iris stoma, increase pigmented granule number and size in iris epithelial cells, and decrease actin filament in iris muscle fiber cells. Consequently, ripasudil hydrochloride hydrate decreases the intraocular pressure by improving the conventional outflow and may also facilitate the unconventional outflow via intercellular space widening without serious side effects.
- Published
- 2019
88. Effect of ripasudil on diabetic macular edema
- Author
-
Yoshiro Minami, Youngseok Song, Tsuneaki Omae, Satoshi Ishiko, Akihiro Ishibazawa, Tomoko Ro-Mase, and Akitoshi Yoshida
- Subjects
0301 basic medicine ,Male ,Intraocular pressure ,Visual acuity ,genetic structures ,Visual Acuity ,Ocular hypertension ,Glaucoma ,lcsh:Medicine ,chemistry.chemical_compound ,0302 clinical medicine ,lcsh:Science ,Aged, 80 and over ,Sulfonamides ,rho-Associated Kinases ,Multidisciplinary ,Middle Aged ,Vascular endothelial growth factor ,Female ,medicine.symptom ,Glaucoma, Open-Angle ,Tomography, Optical Coherence ,Adult ,medicine.medical_specialty ,Diabetic macular edema ,Article ,Macular Edema ,Diabetes Complications ,03 medical and health sciences ,Ophthalmology ,medicine ,Diabetes Mellitus ,Humans ,Antihypertensive Agents ,Intraocular Pressure ,Aged ,Retrospective Studies ,Diabetic Retinopathy ,business.industry ,Significant difference ,lcsh:R ,medicine.disease ,Isoquinolines ,eye diseases ,030104 developmental biology ,chemistry ,Ocular Hypertension ,lcsh:Q ,Ripasudil ,sense organs ,Ophthalmic Solutions ,business ,030217 neurology & neurosurgery - Abstract
The current study aimed to address whether ripasudil, a Rho-associated coiled-coil containing protein kinase (ROCK) inhibitor developed to treat glaucoma and ocular hypertension (OH), improves diabetic macular edema (DME) since it is known that ROCK upregulates vascular endothelial growth factor. We retrospectively investigated the foveal thickness (FT) measured by spectral-domain optical coherence tomography, visual acuity (VA), and intraocular pressure (IOP) in 12 eyes with DME that received ripasudil treatment for primary open-angle glaucoma or OH and compared them with 14 eyes that received no treatment. One month after ripasudil therapy, the mean FT decreased significantly from 439 ± 72 µm to 395 ± 62 µm (P = 0.003); this change was significantly different from that in the controls, in which the mean FT increased by 1 ± 39 µm (P = 0.01). Ripasudil also caused a significant decrease in IOP from 17.3 ± 5.2 mmHg to 14.6 ± 4.0 mmHg (P = 0.02); this change was significantly greater than that in the controls, in which IOP changed by 0.0 ± 1.6 mmHg (P
- Published
- 2019
89. Evaluation of offset of conjunctival hyperemia induced by a Rho-kinase inhibitor; 0.4% Ripasudil ophthalmic solution clinical trial
- Author
-
Tamaki Sumi, Kentaro Tada, Tsuyoshi Yoneda, Waka Ishida, Yoshiaki Kiuchi, Etsuko Terao, Atsuki Fukushima, Hajime Kuroiwa, Koji Jian, Tatsuma Kishimoto, Hideaki Okumichi, Emi Sakamoto, Ken Fukuda, Yasuko Fujisawa, and Shunsuke Nakakura
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,genetic structures ,Glaucoma ,Ocular hypertension ,lcsh:Medicine ,Hyperemia ,Article ,Conjunctival Diseases ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Conjunctival hyperemia ,Prospective Studies ,Adverse effect ,Prospective cohort study ,lcsh:Science ,Aged ,Aged, 80 and over ,Sulfonamides ,Multidisciplinary ,business.industry ,lcsh:R ,Middle Aged ,medicine.disease ,Isoquinolines ,eye diseases ,Clinical trial ,body regions ,030104 developmental biology ,chemistry ,Rho kinase inhibitor ,Case-Control Studies ,cardiovascular system ,Female ,Ocular Hypertension ,lcsh:Q ,Ripasudil ,sense organs ,Ophthalmic Solutions ,business ,030217 neurology & neurosurgery ,Glaucoma, Open-Angle - Abstract
Glaucoma leads to irreversible blindness. Numerous anti-glaucoma eye drops have been developed. Unfortunately, many patients with glaucoma still suffer from progressive visual disorders. Recently, ripasudil hydrochloride hydrate, a selective Rho-associated protein kinase inhibitor, was launched for the treatment of glaucoma. However, adverse events, such as conjunctival hyperemia, are often noted in clinical trials using healthy subjects. Therefore, we investigated the onset, offset, and kinetic changes of conjunctival hyperemia induced by ripasudil ophthalmic solution in patients with open-angle glaucoma or ocular hypertension who had already been treated with anti-glaucoma eye drops other than ripasudil. Conjunctival hyperemia was evaluated by both clinical grading by 3 ophthalmic physicians and pixel coverage of conjunctival blood vessels determined by conjunctival hyperemia-analyzing software. Conjunctival hyperemia appeared within 10 min post-instillation in most of the participants. Clinical grade and pixel coverage increased significantly 10 min post-instillation and then decreased. In most of the participants, hyperemia resolved within 2 h. Median conjunctival hyperemia offset was 90 min. A tendency of monotonic increase was observed between clinical grade and pixel coverage. Taken altogether, hyperemia induced by ripasudil was transient in glaucoma patients who had already been treated with anti-glaucoma eye drops other than ripasudil.
- Published
- 2019
90. New Insights Into Corneal Endothelial Regeneration
- Author
-
Mansab Jafri and Kathryn Colby
- Subjects
Corneal endothelium ,genetic structures ,business.industry ,Endothelial regeneration ,medicine.disease ,Clinical Practice ,Ophthalmology ,Important research ,chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,Cornea ,medicine ,Research questions ,sense organs ,Ripasudil ,Endothelial dysfunction ,business ,Neuroscience - Abstract
This article reviews our current understanding of the regenerative capacity of the corneal endothelium and critically evaluates new and important research in the treatment of endothelial dysfunction. The development and application of new surgical (Descemet’s membrane stripping only), pharmacologic (rho kinase inhibitors, such as ripasudil), and injectable cell culture modalities for the treatment of endothelial dysfunction have sparked debate in the cornea world and may revolutionize future clinical practice. The exact mechanisms involved in corneal endothelial regeneration remain elusive. The latest treatment strategies for endothelial dysfunction have the potential to transform our previous perceptions of endothelial physiology by eliciting new and exciting research questions for future investigations.
- Published
- 2019
91. Assessing the Effects of Ripasudil, a Novel Rho Kinase Inhibitor, on Human Corneal Endothelial Cell Health
- Author
-
Andrew S. Goldstein, Benjamin T. Aldrich, Mark A. Greiner, Jessica M. Skeie, Gregory A. Schmidt, Cynthia R. Reed, and M. Bridget Zimmerman
- Subjects
0301 basic medicine ,Pharmacology ,Corneal endothelium ,Metabolic function ,Mitochondrial respiration ,eye diseases ,Cell biology ,03 medical and health sciences ,Ophthalmology ,chemistry.chemical_compound ,030104 developmental biology ,0302 clinical medicine ,chemistry ,Rho kinase inhibitor ,030221 ophthalmology & optometry ,Pharmacology (medical) ,Corneal endothelial cell ,sense organs ,Viability assay ,Ripasudil - Abstract
To determine how the Rho kinase inhibitor, ripasudil, affects metabolic function and cell viability in donor human corneal endothelial cells (HCECs).Endothelial cell-Descemet membrane (EDM) tissues were treated with 10 μM ripasudil and assayed for mitochondrial and glycolytic activity using extracellular flux analysis and then compared to untreated controls. In addition, EDM tissues with a 24-h ripasudil treatment and control tissues were exposed to 1 μM staurosporine to induce apoptosis and then analyzed for cell viability using apoptosis and necrosis assays.Mitochondrial respiration metrics, specifically maximal respiration (P = 0.758) and spare respiratory capacity (P = 0.777), did not differ among the 1-h ripasudil treatment, 24-h treatment, and untreated tissues. Glycolytic activity assays showed an increase in glycolytic capacity at 1 h compared to the 24-h exposure group (P = 0.049) and controls (P = 0.009). Following exposure to staurosporine, the percentage of apoptotic HCECs was lower (P = 0.009) in ripasudil-treated tissues (2.473%, standard error of the mean [SEM] 0.477%) compared to untreated controls (3.349%, SEM 0.566%). In contrast, the percentage of necrotic HCECs decreased but did not differ statistically (P = 0.158) between ripasudil-treated (3.789%, SEM 0.487%) and untreated (4.567%, SEM 0.571%) tissues.Exposures to ripasudil did not result in any detectable reduction in metabolic function for HCECs in an ex vivo donor tissue model, and an increase in glycolytic activity at the 1-h time point was detected. In addition, HCECs treated with ripasudil gained a protective effect against induced apoptosis, suggesting that ripasudil may help improve the integrity of the corneal endothelium.
- Published
- 2018
92. Rho Kinase Inhibitors as a Novel Treatment for Glaucoma and Ocular Hypertension
- Author
-
Mark Johnson and Angelo P. Tanna
- Subjects
0301 basic medicine ,Intraocular pressure ,genetic structures ,medicine.medical_treatment ,Ocular hypertension ,Glaucoma ,Context (language use) ,Pharmacology ,Benzoates ,Article ,Aqueous Humor ,Translational Research, Biomedical ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Glaucoma surgery ,medicine ,Humans ,Latanoprost ,Rho-associated protein kinase ,Antihypertensive Agents ,Intraocular Pressure ,Sulfonamides ,rho-Associated Kinases ,business.industry ,Isoquinolines ,medicine.disease ,eye diseases ,Ophthalmology ,030104 developmental biology ,chemistry ,beta-Alanine ,030221 ophthalmology & optometry ,Ocular Hypertension ,sense organs ,Ripasudil ,business ,Glaucoma, Open-Angle - Abstract
In an elegant example of bench-to-bedside research, a hypothesis that cells in the outflow pathway actively regulate conventional outflow resistance was proposed in the 1990s and systematically pursued, exposing novel cellular and molecular mechanisms of intraocular pressure (IOP) regulation. The critical discovery that pharmacologic manipulation of the cytoskeleton of outflow pathway cells decreased outflow resistance placed a spotlight on the Rho kinase pathway that was known to regulate the cytoskeleton. Ultimately, a search for Rho kinase inhibitors led to the discovery of several molecules of therapeutic interest, leaving us today with 2 new ocular hypotensive agents approved for clinical use: ripasudil in Japan and netarsudil in the United States. These represent members of the first new class of clinically useful ocular hypotensive agents since the US Food and Drug Administration approval of latanoprost in 1996. The development of Rho kinase inhibitors as a class of medications to lower IOP in patients with glaucoma and ocular hypertension represents a triumph in translational research. Rho kinase inhibitors are effective alone or when combined with other known ocular hypotensive medications. They also offer the possibility of neuroprotective activity, a favorable impact on ocular blood flow, and even an antifibrotic effect that may prove useful in conventional glaucoma surgery. Local adverse effects, however, including conjunctival hyperemia, subconjunctival hemorrhages, and cornea verticillata, are common. Development of Rho kinase inhibitors targeted to the cells of the outflow pathway and the retina may allow these agents to have even greater clinical impact. The objectives of this review are to describe the basic science underlying the development of Rho kinase inhibitors as a therapy to lower IOP and to summarize the results of the clinical studies reported to date. The neuroprotective and vasoactive properties of Rho kinase inhibitors, as well as the antifibrotic properties, of these agents are reviewed in the context of their possible role in the medical and surgical treatment of glaucoma.
- Published
- 2018
93. The ROCK Inhibitor Ripasudil Shows an Endothelial Protective Effect in Patients With Low Corneal Endothelial Cell Density After Cataract Surgery
- Author
-
Hisataka Fujimoto, Junichi Kiryu, and Yoshinao Setoguchi
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Corneal endothelium ,Endothelium ,genetic structures ,medicine.medical_treatment ,Biomedical Engineering ,ripasudil ,Glaucoma ,Cataract ,Article ,ROCK inhibitor ,03 medical and health sciences ,chemistry.chemical_compound ,corneal endothelium ,0302 clinical medicine ,Japan ,Cornea ,Humans ,Medicine ,Sulfonamides ,rho-Associated Kinases ,business.industry ,Endothelial Cells ,Surgical wound ,Cataract surgery ,Isoquinolines ,medicine.disease ,protection ,eye diseases ,Surgery ,Ophthalmology ,030104 developmental biology ,medicine.anatomical_structure ,chemistry ,030221 ophthalmology & optometry ,Bullous keratopathy ,Ripasudil ,sense organs ,business - Abstract
Purpose In the field of regenerative medicine, Rho kinase inhibitors (ROCK inhibitors) show a protective effect on the corneal endothelium and promote effective healing in acute surgical wounds. In this study, we investigated the effectiveness of eyedrops containing ripasudil, a ROCK inhibitor approved in Japan for therapeutic use for glaucoma. Methods In this retrospective observational study, 13 glaucoma patients (16 eyes) were treated with 0.4% ripasudil eyedrops twice a day after cataract surgery. The control group comprised 13 patients (17 eyes). The averaged corneal endothelial cell density from one central and four paracentral points was
- Published
- 2021
94. The Additive Effect of ROCK Inhibitor on Prostaglandin-Treated Japanese Patients with Glaucoma Indicating 15 mmHg and Under: ROCK U-15
- Author
-
Hitomi Saito, Shiroaki Shirato, Rei Sakata, Makoto Aihara, Takashi Fujishiro, and Megumi Honjo
- Subjects
Male ,030213 general clinical medicine ,Intraocular pressure ,medicine.medical_specialty ,Open angle glaucoma ,genetic structures ,Prostaglandin ,Glaucoma ,FP receptor agonist ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Japan ,Internal medicine ,Ophthalmology ,Medicine ,Humans ,Pharmacology (medical) ,Adverse effect ,Blepharitis ,Open-angle glaucoma ,Antihypertensive Agents ,Original Research ,rho-Associated Kinases ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Rheumatology ,eye diseases ,Ripasudil ,Treatment Outcome ,chemistry ,030220 oncology & carcinogenesis ,Prostaglandins ,Japanese ,sense organs ,business ,Glaucoma, Open-Angle - Abstract
Introduction We aimed to evaluate the additional effects and safety of a Rho-associated protein kinase (ROCK) inhibitor, ripasudil hydrochloride hydrate, in Japanese patients with primary open-angle glaucoma (POAG) with an intraocular pressure (IOP) of at most 15 mmHg undergoing prostaglandin F2α (FP) receptor agonist monotherapy (FP monotherapy). Methods In this prospective observational study, 30 Japanese patients with POAG and IOP of at most 15 mmHg (mean age 59.4 years; 10 men) who were undergoing FP monotherapy in both eyes were administered an additional dose of ripasudil hydrochloride hydrate (GLANATEC ophthalmic solution 0.4%: ripasudil) in one eye. The following factors were investigated at 1 and 3 months after the initiation of ripasudil treatment: (1) magnitude of change in IOP between the treated and contralateral untreated eyes, (2) number of treated eyes showing 20% and 30% IOP reduction, (3) IOP difference between treated and contralateral untreated eyes, and (4) safety during the treatment period. Both (1) and (3) were analyzed using the mixed-effect model for repeated measurements. Results The treated eyes showed significant reduction in IOP at 1 month (− 1.92 mmHg, P
- Published
- 2021
95. Responsiveness to ripasudil may be a potential outcome marker for selective laser trabeculoplasty in patients with primary open-angle glaucoma
- Author
-
Kazuyuki Hirooka, Yoshiaki Kiuchi, Hiroki Nii, and Taro Baba
- Subjects
Male ,030213 general clinical medicine ,medicine.medical_specialty ,Intraocular pressure ,Open angle glaucoma ,genetic structures ,medicine.medical_treatment ,Science ,Glaucoma ,Diseases ,Trabeculectomy ,Kaplan-Meier Estimate ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Medical research ,Ophthalmology ,Glaucoma surgery ,Medicine ,Humans ,Protein Kinase Inhibitors ,Survival analysis ,Aged ,Retrospective Studies ,Aged, 80 and over ,Sulfonamides ,Multidisciplinary ,business.industry ,Proportional hazards model ,Therapeutic effect ,medicine.disease ,Isoquinolines ,eye diseases ,Treatment Outcome ,chemistry ,030221 ophthalmology & optometry ,Female ,Ripasudil ,sense organs ,Laser Therapy ,business ,Glaucoma, Open-Angle - Abstract
We examined responsiveness to ripasudil as a potential factor for predicting the effect of selective laser trabeculoplasty (SLT) when performed for primary open-angle glaucoma (POAG). A total of 70 eyes with no history of glaucoma surgery underwent SLT between January 2015 and June 2019. Patients were divided into two groups, with an intraocular pressure (IOP) decrease of 15% or more due to ripasudil administration before SLT defined as the effective group, while an IOP decrease of less than 15% was defined as the non-effective group. Kaplan–Meier survival analysis was performed. A Cox proportional hazards model assessed the influence of baseline factors on the success. Of the 70 eyes evaluated, treatments were effective in 22 and non-effective in 48. Postoperatively, both groups exhibited IOP reductions for up to 24 months. Success ratios at 12 and 24 months after SLT were 43.5% and 18.5% in the effective versus 24.9% and 9.3% in the non-effective group, which were significantly higher in the effective group (P = 0.03). Presence of a ripasudil effective eye (P = 0.03) was associated with treatment success. Responsiveness to ripasudil may be useful in predicting the therapeutic effect of SLT.
- Published
- 2021
96. Rho kinase (ROCK) inhibitors in the management of corneal endothelial disease
- Author
-
Zeba A Syed and Christopher J. Rapuano
- Subjects
Fuchs Endothelial Dystrophy ,Glaucoma ,Benzoates ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Tissue engineering ,Cornea ,medicine ,Humans ,Rho-associated protein kinase ,Protein Kinase Inhibitors ,Retina ,Sulfonamides ,rho-Associated Kinases ,business.industry ,Fuchs' Endothelial Dystrophy ,General Medicine ,medicine.disease ,Isoquinolines ,eye diseases ,Ophthalmology ,medicine.anatomical_structure ,chemistry ,Apoptosis ,030221 ophthalmology & optometry ,Cancer research ,beta-Alanine ,sense organs ,Ripasudil ,business ,030217 neurology & neurosurgery - Abstract
Purpose of review Rho kinase (ROCK) inhibitors are growing increasingly relevant in ophthalmology, and the goal of this review is to summarize their mechanisms of action and potential applications in the subspecialties of glaucoma, retina, and cornea. We will focus specifically on corneal endothelial wound healing, for which ROCK inhibition demonstrates particular promise. Recent findings ROCK inhibition has been shown to promote corneal endothelial cell proliferation, increase intercellular adhesion, and suppress apoptosis. Topical ROCK inhibitor treatment has exhibited potential use in Fuchs endothelial dystrophy, corneal edema from acute surgical trauma and other etiologies, and tissue engineering therapy for the endothelial disease. Ripasudil and netarsudil, the two ROCK inhibitors available for ophthalmic use, are generally very well tolerated with mild and transient local side effects. Summary ROCK inhibitors are revolutionizing the subspecialty of cornea, and further research is needed to compare long-term outcomes of ROCK inhibitor therapy to those of conventional endothelial keratoplasty, including visual acuity and endothelial cell density. Other possible avenues include the use of ROCK inhibitors to prolong corneal graft survival, and early data appears promising.
- Published
- 2021
97. Effect of intravitreal Rho kinase inhibitor ripasudil (K-115) on feline retinal microcirculation.
- Author
-
Nakabayashi, Seigo, Kawai, Motofumi, Yoshioka, Takafumi, Song, Yong-Seok, Tani, Tomofumi, Yoshida, Akitoshi, and Nagaoka, Taiji
- Subjects
- *
OCULAR hypotony , *KINASE inhibitors , *MICROCIRCULATION , *ISOQUINOLINE , *RETINAL blood vessels , *PREPROENDOTHELIN , *DRUG efficacy , *THERAPEUTICS - Abstract
Ripasudil (K-115) is a novel Rho kinase inhibitor with a potent intraocular pressure-lowering effect. However, it is unclear whether ripasudil affects the retinal blood flow (RBF). We investigated the effect of ripasudil on feline retinal microcirculation. Ripasudil (5 μM, 50 μM or 5 mM; n = 5 each concentration) or vehicle (PBS; n = 5) was injected intravitreally. The vessel diameter (D) and blood velocity (V) were measured by laser Doppler velocimetry simultaneously in the first-order retinal arterioles and the RBF was calculated. The measurements started 5 min before the injection and were performed every 10 min for 120 min. After the intravitreal injection, the retinal circulatory parameters did not change significantly in PBS or 5 μM of ripasudil. The blood V and RBF increased significantly compared to baseline, whereas the vessel D did not change significantly in 50 μM and 5 mM of ripasudil. The V in 50 μM, and the V and RBF in 5 mM of ripasudil significantly increased compared to those in PBS. Intravitreal administration of ripasudil increased the blood V and RBF in cats, suggesting that ripasudil has the potential to improve the retinal blood flow. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
98. Intra-ocular pressure-lowering effects of a Rho kinase inhibitor, ripasudil (K-115), over 24 hours in primary open-angle glaucoma and ocular hypertension: a randomized, open-label, crossover study.
- Author
-
Tanihara, Hidenobu, Inoue, Toshihiro, Yamamoto, Tetsuya, Kuwayama, Yasuaki, Abe, Haruki, Suganami, Hideki, and Araie, Makoto
- Subjects
- *
INTRAOCULAR pressure , *KINASE inhibitors , *OPEN-angle glaucoma , *HYPERTENSION , *PLACEBOS , *PATIENTS , *THERAPEUTICS - Abstract
Purpose To investigate the intra-ocular pressure ( IOP)-lowering effects of a selective Rho kinase inhibitor, ripasudil (K-115), over 24 hr in patients with primary open-angle glaucoma ( POAG) or ocular hypertension ( OHT). Methods In this multicenter, prospective, randomized, open-label, 3-period, Latin-square crossover clinical study, 28 patients with POAG or OHT whose IOP level was 21 mmHg or higher were subdivided into three groups. Each patient was treated with placebo and ripasudil in concentrations of 0.2 and 0.4%, at 9:00 and 21:00 on day 1 through a total of 3 periods separated by washout periods. IOP was measured at 9:00, 10:00, 11:00, 13:00, 16:00, 19:00, 21:00, 22:00 and 23:00 on day 1, and 1:00, 4:00, 7:00 and 9:00 on day 2 in sitting position using Goldmann applanation tonometer. Main outcome measure was the IOP reduction of placebo and ripasudil from baseline. Results The mean IOP reduction was −5.2 mmHg for 0.2%, −6.4 mmHg for 0.4% and −2.0 mmHg for placebo at 2 hr after the first instillation. Also, the corresponding values were −6.8 mmHg for 0.2%, −7.3 mmHg for 0.4% and −4.1 mmHg for placebo at 2 hr after the second instillation. Statistically significant IOP reduction, compared with placebo, was found for both 0.2 and 0.4% from 1 through 7 hr after each instillation. In safety, conjunctival hyperaemia was observed in 22 patients (79%) for 0.2%, 27 patients (96%) for 0.4% and three patients (11%) for placebo. Conclusion Ripasudil is a promising new topical medication to lower IOP for at least 7 hr after instillations in patients with POAG or OHT. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
99. Intraocular pressure-lowering effects of Ripasudil: a potential outcome marker for Trabeculotomy
- Author
-
Goda, Erina, Hirooka, Kazuyuki, Mori, Kazuhiko, and Kiuchi, Yoshiaki
- Published
- 2019
- Full Text
- View/download PDF
100. Topical Ripasudil as First Line Treatment for Ocular Hypertension in Uveitis Cases: AnAnalytic Study
- Author
-
Harvinder Nagpal and Mandeep Kaur
- Subjects
medicine.medical_specialty ,genetic structures ,business.industry ,Clinical Biochemistry ,Ocular hypertension ,General Medicine ,medicine.disease ,eye diseases ,corticosteroids ,First line treatment ,chemistry.chemical_compound ,chemistry ,inflammation ,Ophthalmology ,medicine ,Medicine ,sense organs ,Ripasudil ,business ,Uveitis ,intraocular pressure - Abstract
Introduction: Uveitis can directly or indirectly lead to ocular hypertension which can lead to glaucoma. Ripasudil has a different mechanism of action than other anti-glaucoma medications available commercially and in contrary to these drugs, ripasudil also has anti-inflammatory properties providing an upper edge over other intraocular pressure lowering drugs. In addition to primary glaucoma, these new Rho kinase associated inhibitors can provide satisfactory results in glaucoma with secondary pathologies. Aim: To study the role of ripasudil as first line treatment for ocular hypertension in uveitis cases. Materials and Methods: A prospective randomised study comprising 40 patients of Ocular Hypertension (OHT) associated with uveitis was conducted in the Outpatient Department (OPD) of Ophthalmology at a tertiary care hospital in North India from October 2020 to January 2021. The diagnosis of uveitis was made clinically with detailed medical history and slit lamp biomicroscopic examination. All the diagnosed patients were started with topical ripasudil hydrochloride hydrate 0.4% eye drops twice daily along with anti-inflammatory medications. Intraocular Presure (IOP) was recorded after 4 weeks and 12 weeks at 8 am, 10 am and 4 pm. Effectiveness of the drugs was calculated in terms of mmHg fall in mean intraocular pressure using t-test and p-values. Results: Out of 40 patients with uveitis associated OHT, 20caseswere inflammation related (mean age was 56.2±16.3years,13 males, 7 females) and 20 cases were categorised as corticosteroid induced (mean age was 58.9±15.69 years, 14 males, 6 females). At 12 weeks there was 5.67±0.59 mmHg fall in IOP (22.70%) in inflammation related OHT and there was 6.37±0.07 mmHg fall in IOP (25.34%) in corticosteroid related OHT. There was statistically significant fall in IOP (p-value=0.001). Conclusion: This study demonstrated that topical ripasudil hydrochloride hydrate 0.4% eye drops is effective in lowering the IOP, also there were no side effects, so it is safe and well-tolerated. So, ripasudil can provide a safe and effective alternative for lowering of IOP among uveitis related OHT.
- Published
- 2021
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.