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    Drug delivery systems could improve poor adherence


    Bimatoprost SR

    The Bimatoprost SR is a biodegradable implant placed in the anterior chamber with a 28-gauge applicator. After sterile preparation and numbing the eye, the clinician slightly inserts the needle and presses an actuator button to launch a tiny pellet into the eye.

     "The actual procedure itself is pretty minor from the patient's perceptive," said Dr. Myers.

    The pellet falls into the anterior chamber angle, then shrinks as it dissolves.

    In a phase I/II clinical trial (J Ophthalmol, 2017 Mar; 175:137-147), in 75 subjects the treatment rapidly lowered intraocular pressure (IOP) and maintained the reduction. Most patients received only 1 injection.

    Through week 16, patients receiving a 6-μg dose experienced a 7.2 mm Hg reduction in IOP. Those receiving 10-μg dose had a 7.4 mm Hg reduction in IOP, those receiving 15-μg dose got a 8.1 mm Hg reduction, and those receiving 20-μg dose had a 9.5 mm Hg reduction. By comparison, patients treated with topical bimatoprost experienced a 8.4 mm Hg reduction in IOP.

    "Most of the side effects had to do with the procedure itself and they weren't severe," said Dr. Myers.

    Conjunctival hyperemia with onset later than 2 days after the injection procedure affected 17.3% of those receiving topical bimatoprost versus 6.7% of those receiving Bimatoprost SR.

    Seventy-seven percent of patients said they would be extremely or very likely to repeat the procedure, and 83% said they would be extremely or very likely to recommend it.

    "So from the patient's perceptive, it wasn't such a crazy thing to consider an injection every 3 to 4 months," said Dr. Myers.


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