New glaucoma treatment could overcome non-compliance

An angiostatic cortisene, Anercortave Acetate (AA), may prove to be the first treatment modality for open-angle glaucoma, which only needs to be administered every three months.

Initially designed by Alcon and in phase II/III of clinical testing, it was originally intended to treat advanced macular degeneration. Following poor results an attempt was made to use it to treat dry macular degeneration, which also proved futile. However, it may now have a use in glaucoma to reduce IOP in patients.

The drug is injected beneath the conjunctiva, near the front of the eye. According to Alcon, initial proof-of-concept clinical studies demonstrated that AA has the potential for providing IOP reductions for three months or more following a single injection.

A small case study series included a total of eight eyes of seven subjects with medically uncontrolled IOP following intravitreal or sub-Tenon injections of triamcinolone acetonide. According to the study, published in Archives of Ophthalmology Vol. 127 No.2 in February 2009, the subjects received an 0.8 mL anterior juxtascleral depot of 3% AA solution (24 mg) under topical anaesthesia. IOP was then monitored weekly during month 1 and then monthly onwards for a minimum of a year. Initial results have demonstrated that AA is very effective in reversing steroid induced ocular hypertension.

Patient compliance is one of the biggest challenges facing the management of glaucoma. If successful, this form of three monthly delivery system versus drops required on a daily basis has the potential to overcome non-compliance on a huge scale.