The State of Glaucoma Treatment: Medication Burden Reduction, Patient Quality of Life, and More

Nathan M. Radcliffe, Shan Lin, and Arkadiy Yadgarov discuss the benefits of reducing medication burden and improving patient quality of life, noting how this new approach aligns with current strategies in glaucoma treatment, including laser therapy, surgery, and pharmacotherapy.

Shan Lin, MD:

I’m happy to give my thoughts on just what we were talking about. The results of the MORE data are just really impressive. When I first looked at it, I thought, “Well, did we add it on and get this additional 15% to 20%?” No. Replacing 1, 2, and sometimes 3 drops, and you’re still getting 15% to 20% lowering. I was just so surprised, pleasantly surprised.

Because now you not only have helped your glaucoma patient, every millimeter counts, which was the point if we’re going to change the therapy. But now we’ve also helped to consolidate that into one bottle.

And I can’t tell you how many patients are frustrated with using multiple bottles. Of course, compliance, they’re usually pretty honest, and, “I forget the middle of the day drop,” or, “I forget the one in the morning because I’m rushing to work.” So how much that makes their life better. So I’m very impressed.

Arkadiy Yadgarov, MD:

Yeah. I think ultimately the MORE study feeds in really, really well to what most glaucoma specialists are focusing on, which is medication burden reduction, quality of life improvement for patients, and stability of glaucoma with less reliance on medications and multiple daily usage of medicine.

So SLT was a big part of that picture, MIGS is a big part of that picture. And finally, the MORE study has introduced Rocklatan as part of that picture. Medication burden reduction, excellent IOP results, and less reliance on adherence for treatment.

So I think this is a very much needed and pleasant surprise for us in terms of the studies. As Shan said, I mean it was, no, it’s not just additional pressure lowering, it’s medication reduction. I mean, it’s phenomenal.

So I think we will see more and more doctors use these results because it’s a no-brainer. And I think with Nate saying, “You start with all those patients in your clinics that are latanoprost and 2 other ingredients, and every single one of them should go ahead and try a Rocklatan trial.” I mean, there’s really no reason not to, I think, in my mind. So I think we’ll see where this goes, but it’s an exciting time.

Nathan M. Radcliffe, MD:

Yeah. And I really love what you just said there, Arkadiy, which is that we have multiple lines. Laser’s one thing, surgery is another, pharmacotherapy is different, but they’re all kind of pointing in the same direction. The trabecular meshwork is an important target for us to start early in glaucoma therapy, that’s across surgery, laser, and now pharmacotherapy is a great thing.

We recognize across all 3, that compliance and medication tolerability is a challenge for patients, and that if we can limit them to as few bottles, or even one, as possible, that will be a benefit. Whether it’s reducing medication load with MIGS, with laser, or with pharmacotherapy changes that we can do.

And it’s really nice to see that all these are moving in the direction of better IOP reduction, earlier aggressive intervention, and ultimately focusing on the patient’s quality of life. They have better things to do than put 6 drops in per day, and we’re helping them. And it’s just I feel like the past 20 years of my career are all kind of culminating in this discussion, and that’s a great feeling.

I’ll thank both of you for joining me tonight, and I learned a ton. Thank you, Shan. Thank you, Arkadiy. And I’ll thank all of our listeners, and I hope you learned a lot listening to these bright gentlemen tonight as well.

Arkadiy Yadgarov, MD:

Thank you.

Shan Lin, MD:

Thanks.