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Spotlight on VYZULTA®

Ophthalmology 360

This Spotlight Series article is editorially independent content.

Glaucoma is the leading cause of visual impairment and irreversible blindness worldwide, with primary open-angle glaucoma (POAG) as the most prevalent form. Elevated intraocular pressure (IOP), or ocular hypertension (OHT), is a key risk for progression and remains the only modifiable clinical factor that can be addressed with pharmacologic therapy, laser therapy, or surgery.1

VYZULTA®: Dual-Action Eye Drops

Guidelines from the American Optometric Association recommend prostaglandin analogs (PGAs) as first-line treatment for patients with POAG or OHT, unless contraindicated. Clinical evidence indicates that PGAs provide the greatest reduction in IOP among topical monotherapy agents.1

Approved by the US Food and Drug Administration (FDA) in 2017, VYZULTA (latanoprostene bunod ophthalmic solution; Bausch & Lomb) 0.024% is a PGA indicated for the reduction of IOP in patients with OAG or OHT. This once-daily monotherapy is the only PGA that delivers nitric oxide as part of a dual mechanism of action with lantanoprost acid to increase aqueous outflow and reduce IOP.2,3

Efficacy Data

The efficacy and safety of VYZULTA have been evaluated in randomized, controlled trials and real-world analyses.

PIVOTAL Studies

APOLLO and LUNAR were two randomized, multicenter, double-masked, parallel-group 3-month, phase 3 studies comparing once-daily VYZULTA versus twice-daily timolol 0.5% in patients with OAG or OHT. VYZULTA provided significantly greater IOP reduction from baseline versus timolol 0.5%, with mean reductions of 7.5 mmHg to 9.1 mmHg through month 3.4,5

In a pooled analysis of APOLLO and LUNAR, patients who switched from timolol 0.5% to VYZULTA at month 3 achieved additional IOP reduction through month 12 (see FIGURE 1).6

JUPITER Study

JUPITER was a single-arm, multicenter, open-label, 52-week, phase 3 study evaluating the long-term safety and IOP-lowering efficacy of VYZULTA in 130 Japanese patients with OAG or OHT. Most patients (74.6%) had a baseline IOP of 15 mmHg to 21 mmHg. At week 52, mean IOP reduction from baseline was 26.3%, with consistent reductions observed over 1 year at all visits (see FIGURE 2).7

Real-World Study

LEEP was an open-label, non-controlled, prospective, 6-week, multicenter, observational study conducted in Canada in patients with elevated IOP and OAG or OHT. Patients were receiving ≤3 IOP-lowering agents and had either inadequate control or treatment-limiting adverse effects. Patients with prior selective laser trabeculoplasty >90 days before enrollment were eligible.

Findings support the use of VYZULTA across diverse patient populations. Significant IOP reduction was observed across the study cohort (see FIGURE 3).8

Safety and Tolerability

VYZULTA has a favorable adverse event (AE) profile, with a low incidence of hyperemia. Among treated patients, 0.6% discontinued therapy because of an ocular AE.2 In a pooled analysis of APOLLO and LUNAR, VYZULTA demonstrated a safety profile comparable to other PGAs. The most common ocular AEs (incidence ≥2%) were conjunctival hyperemia, eye irritation, eye pain, ocular hyperemia, and instillation site pain.6 No cases of corneal verticillata or treatment-related conjunctival hemorrhage were reported in the pivotal trials.3

Dosing and Administration

The recommended dosage is 1 drop in the affected eye(s) once daily in the evening. VYZULTA should not be administered more than once daily, as more frequent dosing may reduce the IOP- lowering effect. VYZULTA may be used concomitantly with other ophthalmic eye drops; if multiple topical agents are used, administer them at least 5 minutes apart. Contact lenses should be removed prior to instillation and may be reinserted after 15 minutes.2

For more information, visit https://www.vyzultahcp.com.

References

  1. American Optometric Association. Evidence-based clinical practice guideline: care of the patient with primary open-angle glaucoma. Approved October 5, 2024. Accessed March 30, 2026. https://www.aoa.org/AOA/Documents/Practice%20Management/Clinical%20Guidelines/EBO%20Guidelines/2024_FINAL%20EBO_Glaucoma_Guideline_digital_10_28_24.pdf
  2. VYZULTA. Package insert. Bausch & Lomb; 2024.
  3. Data on file. Bausch & Lomb Inc.
  4. Weinreb RN, Scassellati Sforzolini B, Vittitow J, Liebmann J. Latanoprostene bunod 0.024% versus timolol maleate 0.5% in subjects with open-angle glaucoma or ocular hypertension: the APOLLO study. Ophthalmology. 2016;123(5):965-73. doi:10.1016/j.ophtha.2016.01.019
  5. Medeiros FA, Martin KR, Peace J, Scassellati Sforzolini B, Vittitow JL, Weinreb RN. Comparison of latanoprostene bunod 0.024% and timolol maleate 0.5% in open-angle glaucoma or ocular hypertension: the LUNAR study. Am J Ophthalmol. 2016;168:250-259. doi:10.1016/j.ajo.2016.05.012
  6. Weinreb RN, Liebmann JM, Martin KR, Kaufman PL, Vittitow JL. Latanoprostene bunod 0.024% in subjects with open-angle glaucoma or ocular hypertension: pooled phase 3 study findings. J Glaucoma. 2018;27(1):7-15. doi:10.1097/IJG.0000000000000831
  7. Kawase K, Vittitow JL, Weinreb RN, Araie M; JUPITER Study Group. Long-term safety and efficacy of latanoprostene bunod 0.024% in Japanese subjects with open-angle glaucoma or ocular hypertension: the JUPITER study. Adv Ther. 2016;33(9):1612-1627. doi:10.1007/s12325-016-0385-7
  8. Yan D, Hutnik CML, Harasymowycz P. Latanoprostene bunod 0.024% early experience program (LEEP): a Canadian initiative for open-angle glaucoma and ocular hypertension. Ophthalmol Ther. 2025;14(6):1311-1323. doi:10.1007/s40123-025-01132-z

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