ABSTRACT

Background: Topical prostaglandin analogs (PGAs) are widely approved and preferred first-line options for glaucoma and elevated intraocular pressure (IOP). However, prostaglandin-associated periorbitopathy syndrome (PAPS) is now a well-recognized clinical and cosmetic concern for patients receiving PGAs, especially during long-term and unilateral therapy. PGA-associated periocular changes occur in a substantial proportion of patients, with older patients (>60 years) at greater risk of clinical presentation. PAPS may hinder long-term management of glaucoma, including treatment adherence, ophthalmic surgery outcomes, and reliable IOP measurements. Recommendation: New therapeutic approaches may address this unmet clinical need. Omidenepag isopropyl (OMDI) is a novel, non-prostaglandin, selective EP₂ receptor agonist in ongoing development, which provides a unique pharmacological mechanism of action. OMDI appears to provide IOP reductions comparable to PGAs, but without PAPS-related undesirable effects. OMDI may offer a suitable long-term option for patients who demonstrate decreased efficacy, or failure, of PGAs, plus patients with significant PAPS, while fulfilling international guidelines.

摘要

背景：局部前列腺素类似物 (PGA) 是广泛批准和首选的青光眼和眼内压升高 (IOP) 的一线选择。然而，前列腺素相关的眶周病综合征（PAPS）现在是接受 PGA 的患者公认的临床和美容问题，特别是在长期和单侧治疗期间。PGA 相关的眼周变化发生在相当大比例的患者中，老年患者（>60 岁）出现临床表现的风险更大。PAPS 可能会阻碍青光眼的长期管理，包括治疗依从性、眼科手术结果和可靠的眼压测量。建议：新的治疗方法可以解决这一未满足的临床需求。Omidenepag isopropyl (OMDI) 是一种新型的非前列腺素选择性 EP ₂正在开发中的受体激动剂，它提供了独特的药理作用机制。OMDI 似乎提供与 PGA 相当的 IOP 降低，但没有与 PAPS 相关的不良影响。OMDI 可能为 PGA 疗效下降或失败的患者以及 PAPS 显着的患者提供合适的长期选择，同时满足国际指南。