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70 | EYEWORLD | JANUARY/FEBRUARY 2020 G PHARMACEUTICAL FOCUS UCOMA by Maxine Lipner Senior Contributing Writer patients achieved lower IOPs than with lata- noprost or netarsudil alone," Dr. Trubnik said. This may allow some to attain pressures under 14 mm Hg, something that may be even more important in patients with normal tension glau- coma, Dr. Trubnik noted. Jacob Brubaker, MD, described a low-ten- sion glaucoma patient who had a pressure of 16 mm Hg on a prostaglandin and Cosopt (dorzolamide hydrochloride/timolol maleate, Akorn Pharmaceuticals) who needed better pressure control. One month after switching to Rocklatan, the patient came in with a pressure of 10 mm Hg. "The beauty of this combination is that while the patient is on four medications, he is still only using two bottles," Dr. Brubaker said. Making the switch Deciding when to use Rocklatan can vary. Dr. Huang views Rocklatan as a good switch for those who are already on prostaglandin mono- therapy. "If they need additional therapy, it's easy to switch them to Rocklatan so that they have two medications on board," Dr. Huang said, adding that those with compliance issues, as well as those with low-tension glaucoma, can get a real boost from the addition of the netar- sudil component in the combination. Dr. Zhang usually still prescribes a pros- taglandin as the first-line agent, but then is amenable to adding Rocklatan. "Instead of T he new fixed-dose combination agent Rocklatan (netarsudil/latanoprost, Aerie Pharmaceuticals), which gained FDA approval in March 2019, is garnering traction in many glaucoma practices. "I think it's exciting to have the opportunity to have this medica- tion available, especially as a once-daily formula- tion," Amy Zhang, MD, said. For Dr. Zhang, this fixed-dose combination agent brings with it the potential for increased patient compliance. "By having combinations, it allows for less chance of someone not using the drop," she said, adding that the dosing is easier since it requires instilling just one drop instead of two. Another benefit of the fixed-dose com- bination is that fewer preservatives and other additives are placed on the ocular surface where damage/toxicity can result, according to Linda Huang, MD. "Additionally, you're increasing the likelihood that patients are getting the drop in," Dr. Huang said, adding that they're not putting in one drop and having to wait 5–10 minutes to instill another. You don't risk someone falling asleep before instilling all of their drops, she said. Valerie Trubnik, MD, said that Rockla- tan increased pressure lowering compared to either single agent in the combination, as seen in the FDA trials. "More than 60% of patients achieved greater than 30% reduction, and more Bringing Rocklatan into the glaucoma fold About the doctors Jacob Brubaker, MD Sacramento Eye Consultants Sacramento, California Linda Huang, MD Glaucoma Institute of Northern New Jersey Rochelle Park, New Jersey Valerie Trubnik, MD Ophthalmic Consultants of Long Island Long Island, New York Amy Zhang, MD Clinical assistant professor of ophthalmology University of Michigan Ann Arbor, Michigan Relevant disclosures Brubaker: Aerie Pharmaceuticals Huang: Aerie Pharmaceuticals Trubnik: None Zhang: None Contact Brubaker: jacobbrubaker@me.com Huang: lindayh@gmail.com Trubnik: valerietrubnik@yahoo.com Zhang: amydzhang@gmail.com FACEBOOK @EyeWorldMagazine TWITTER EyeWorldMag INSTAGRAM @eyeworldmagazine EYEWORLD 24/7 YOUTUBE EyeWorldTV.com

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