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    New glaucoma therapy offers first drug option in years

    Latanoprostene bunod increases outflow through the trabecular meshwork and Schlemm's canal


    Mechanism of action

    Vyzulta is “not just another IOP-lowering drug,” said Calvin Roberts, MD, chief medical officer, Bausch + Lomb.

    IOP elevation occurs as the result of decreased aqueous outflow through the trabecular meshwork. Other drugs on the market “use a different mechanism of action to lower IOP other than via the conventional pathway,” Dr. Roberts said. Latanoprostene bunod targets the trabecular meshwork with the addition of the NO component.

    Latanoprostene bunod cleaves into latanoprost acid and butanediol mononitrate (an NO-donating moiety) when exposed to ubiquitous esterases in the ocular environment.1

    “NO increases outflows through the trabecular meshwork and Schlemm's canal,” Dr. Roberts said. “That what's really, really different (about Vyzulta). Rather than compensate with a different mechanism of action, Vyzulta uses the conventional outflow mechanism.”

    NO is a naturally occurring substance that is often used as a mediator throughout the body, Dr. Roberts added.

    “Studies have shown that patients with elevated IOP have decreased levels of NO in the aqueous,” he said. Researchers at Nicox (which originally developed the compound and licensed it to B+L) identified a means to provide NO to restore the inbalance.

    Dr. Roberts is “excited to get feedback from glaucoma specialists once they've had the opportunity in a real world setting to use this on patients.”


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