How Prostaglandin Analogs Revolutionizing Glaucoma Management

Glaucoma is the second leading cause of blindness worldwide, affecting approximately 80 million people globally, with over 3 million of those residing in the U.S. Glaucoma damages the optic nerve by developing fluid that causes intraocular pressure in the eye. If left untreated, elevated intraocular pressure (IOP) can result in irreversible vision loss. So, the therapeutic solution for this condition is to lower that pressure, which prostaglandin analogs (PGAs) do. This blog delivers a comprehensive understanding of prostaglandin analogs and their applications.

What are Prostaglandin Analogs?

Being the mainstay glaucoma treatment since 1996, the prostaglandin analogs have gained popularity among most eye care practitioners for treating glaucoma. Prostaglandin analogs are synthetic drugs that are designed to decrease intraocular pressure (IOP) and enhance aqueous drainage via the uveoscleral pathway. For a glaucoma patient, a recommended dosage is one drop of 50 micrograms per milliliter once daily, which reduces IOP by approximately 30%.

Why Prostaglandin Analogs are Most Widely Used

Compared to other anti-glaucoma medications, prostaglandin analogs stand out as a more efficient drug with a remarkably low incidence of adverse effects. Also, preservatives, such as benzalkonium chloride (BAK) in the formulation, are found to be associated with corneal, conjunctival, and trabecular meshwork toxicity, leading to Ocular Surface Disease (OSD). As a result, both eye care practitioners and patients have recently recognized the potential of medications such as latanoprost, bimatoprost, and travoprost in managing glaucoma, which fuels its demand worldwide.

Some researchers suggest that giving once-a-day dosing of these drugs can cause a long-term IOP reduction in patients with glaucoma, something impossible with other IOP-lowering medications. Their effectiveness in lowering intraocular pressure (IOP) with minimal side effects is promoting their use as first-line treatments for glaucoma worldwide.

Available Medications:

Latanoprost: Approved by the United States Food and Drug Administration (US FDA) in 1996 and seems to be the most effective compared to other PGAs

Travoprost: Approved by the US FDA in the year 2001. The medication is used to treat open-angle glaucoma or ocular hypertension by draining out the fluid in the eye.

Tafluprost: Approved by the US FDA in the year 2008 and has a similar mechanism of action to latanoprost and travoprost.

Bimatoprost: Approved by the US FDA in the year 2001. Due to its dual action, it is the most efficient drug in reducing intraocular pressure. Bimatoprost can lower intraocular pressure by increasing the rate of flow through the pressure-insensitive outflow channel.

Other Applications of Prostaglandin Analogs

Induction of Labor: PGAs such as dinoprostone are used to induce labor by softening or widening the cervix in those women who are ready to deliver a full-term baby. This medication is only applied under the assistance of a medical healthcare professional.

Gastric Ulcers: Misoprostol,prostaglandin E1 analog, is used to prevent and treat stomach ulcers in patients consuming nonsteroidal anti-inflammatory drugs (NSAIDs). This medication protects the stomach by decreasing acid production and enhancing blood flow to the gastric mucosa.

Vitiligo: Vitiligo occurs when your skin starts to lose its color or pigment. Several studies have demonstrated that prostaglandin analogs can treat vitiligo. However, the evidence is still limited.

Hair Loss: Prostaglandin analogs have been found to be effective and safe for treating hair loss. However, the effects still need to be sufficiently studied for hair regeneration.

Are There Any Side Effects?

While prostaglandin analogs have an excellent safety profile, their side effects rely on their use and the individual patient. Some local side effects of prostaglandin analogs (PGAs) are primarily cosmetic, while others, though less common, can cause sight-threatening risks to vision. The ocular side effects of PGAs can include irritation, pain, itching, periocular pigmentation, conjunctival hyperemia, increase in the number and length of eyelashes. In contrast, systemic include headache, myalgia, flu, and abdominal cramps.

Key Launches to Remember

In January 2019, Allergan plc, a leading global pharmaceutical firm, revealed positive 3-month topline results from Bimatoprost SR’s second pivotal clinical trial. Bimatoprost sustained-release implant is designed to reduce IOP in patients with open-angle glaucoma or ocular hypertension.

In March 2020, Allergan’s DURYSTA, a prostaglandin analog developed for IOP reduction in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT), received approval from the U.S. Food and Drug Administration (FDA). With this approval, the company becomes the first to venture into the world of biodegradable sustained-release implants successfully.

Final Note

Increased research on prostaglandin analogs focused on next-generation prostaglandin analogs and novel drug delivery is creating awareness about their enhanced efficiency and minimum side effects among individuals suffering from glaucoma. As a result, the glaucoma market is expected to hit USD 9,154.4 million at a CAGR of 3.2% during the forecast period from 2024 to 2032, according to a report by Polaris Market Research.

Other key drivers supporting the market growth include rising public awareness about eye safety and increasing adoption of protective eyewear in developing nations. Moreover, the rising prevalence of glaucoma among the aging population worldwide drives market opportunities for prostaglandin analog-driven therapeutics and intraocular pressure management