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2018 ; 34
(1-2
): 40-51
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Discovery and Preclinical Development of Netarsudil, a Novel Ocular Hypotensive
Agent for the Treatment of Glaucoma
#MMPMID28609185
Lin CW
; Sherman B
; Moore LA
; Laethem CL
; Lu DW
; Pattabiraman PP
; Rao PV
; deLong MA
; Kopczynski CC
J Ocul Pharmacol Ther
2018[Jan]; 34
(1-2
): 40-51
PMID28609185
show ga
PURPOSE: Rho-associated protein kinase (ROCK) inhibitors lower intraocular
pressure (IOP) by increasing aqueous outflow through the trabecular meshwork
(TM). The preclinical characterization of netarsudil, a new ROCK/norepinephrine
transporter (NET) inhibitor currently in clinical development, is presented
herein. METHODS: The kinase inhibitory activity of netarsudil was compared to its
esterase metabolite, netarsudil-M1, and 3 other ROCK inhibitors using a
commercially available kinase assay kit. Disruption of actin stress fibers was
measured in primary porcine TM cells and disruption of focal adhesions in
transformed human TM (HTM) cells. Induction of fibrosis markers after exposure to
transforming growth factor-?2 (TGF-?2) was conducted in primary HTM cells. Ocular
hypotensive activity and tolerability of topical formulations were evaluated in
normotensive Dutch Belted rabbits and Formosan Rock monkeys. In vitro corneal
metabolism assays were conducted using dog, pig, rabbit, monkey, and human
corneas. In vivo ocular pharmacokinetics was studied in Dutch Belted rabbits.
RESULTS: Netarsudil inhibited kinases ROCK1 and ROCK2 with a K(i) of 1?nM each,
disrupted actin stress fibers and focal adhesions in TM cells with IC(50)s of 79
and 16?nM, respectively, and blocked the profibrotic effects of TGF-?2 in HTM
cells. Netarsudil produced large reductions in IOP in rabbits and monkeys that
were sustained for at least 24?h after once daily dosing, with transient, mild
hyperemia observed as the only adverse effect. CONCLUSION: Netarsudil is a novel
ROCK/NET inhibitor with high potency in biochemical and cell-based assays, an
ability to produce large and durable IOP reductions in animal models, and
favorable pharmacokinetic and ocular tolerability profiles.
|*Drug Discovery
[MESH]
|Animals
[MESH]
|Antihypertensive Agents/administration & dosage/chemistry/*therapeutic use
[MESH]