From the Guidelines
Vyzulta (latanoprostene bunod) is not mentioned in the provided evidence, however, Netarsudil, a Rho kinase inhibitor, is a similar medication that can be used to reduce intraocular pressure in patients with glaucoma. The medication works by increasing trabecular outflow, decreasing episcleral venous pressure, and decreasing aqueous production, resulting in a 10-20% reduction in intraocular pressure 1. Some key points to consider when prescribing Netarsudil include:
- Potential side effects such as conjunctival hyperemia, corneal verticillata, instillation site pain, conjunctival hemorrhage, and keratitis 1
- No known contraindications, but caution should be exercised in patients with certain medical conditions 1
- The medication is not assigned a pregnancy category, and no data exist regarding its use in pregnant women, but animal studies did not demonstrate adverse effects on the developing fetus 1 It's essential to monitor patients closely for any adverse effects and adjust the treatment plan as needed to ensure the best possible outcome in terms of morbidity, mortality, and quality of life. When determining the effectiveness of topical therapy, it's crucial to distinguish between the therapeutic impact of the agent on intraocular pressure and ordinary background spontaneous fluctuations of intraocular pressure 1. A better way to assess intraocular pressure-lowering response is to compare the effect in one eye with multiple baseline measurements in the same eye 1.
From the FDA Drug Label
VYZULTA is a prostaglandin analog indicated for the reduction of intraocular pressure in patients with open-angle glaucoma or ocular hypertension. VYZULTA ®(latanoprostene bunod ophthalmic solution) 0.024% is indicated for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. The main use of Vyzulta is for the reduction of intraocular pressure in patients with open-angle glaucoma or ocular hypertension 2 2.
- Key Indications:
- Open-angle glaucoma
- Ocular hypertension The dosage is one drop in the affected eye(s) once daily in the evening 2.
From the Research
Vyzulta Overview
- Vyzulta, also known as latanoprostene bunod 0.024%, is a nitric oxide-donating prostaglandin F2α analogue used to reduce intraocular pressure (IOP) in patients with open-angle glaucoma (OAG) or ocular hypertension 3.
- It works by increasing aqueous humour outflow through the uveoscleral pathway and the trabecular meshwork pathway, thereby lowering IOP 3.
Efficacy of Vyzulta
- Studies have shown that Vyzulta is noninferior to timolol 0.5% in terms of IOP-lowering efficacy over 3 months in patients with OAG or ocular hypertension 3, 4.
- Vyzulta has also been shown to be superior to timolol 0.5% in some studies, with a greater IOP reduction observed at all but the earliest time point evaluated 4.
- A comparative evaluation of Vyzulta, timolol maleate, and latanoprost ophthalmic solutions found that Vyzulta had the highest reduction in IOP compared to the other two treatments 5.
Safety and Tolerability of Vyzulta
- Vyzulta has been shown to be well tolerated over up to 12 months, with most ocular treatment-emergent adverse events being mild to moderate in severity 3.
- A retrospective chart review found that switching to Vyzulta from prior pharmacotherapy led to a ~25% IOP reduction and appeared to be well tolerated, with no meaningful changes in other ocular outcomes observed 6.
- Common adverse ocular effects of Vyzulta include hyperemia, but these are typically mild to moderate in severity 4, 5.
Clinical Use of Vyzulta
- Vyzulta is approved in the USA for the reduction of IOP in patients with OAG or ocular hypertension 3.
- It is typically administered once daily in the evening, and has been shown to be effective in reducing IOP in patients with OAG or ocular hypertension 3, 4, 5, 6.
- Vyzulta may be a useful treatment option for patients who are not responding to other IOP-lowering medications, or who are experiencing adverse effects from other treatments 7, 6.