Glanatec (ripasudil) / Kowa - LARVOL DELTA

Efficacy of Rho-kinase inhibitor ophthalmic solution on bleb formation after trabeculectomy, a randomized parallel study (clinicaltrials.gov) - P=N/A | N=70 | Completed | Sponsor: Department of Ophthalmology, Hiroshima University Hospital | Unknown status ➔ Completed

Trial completion • Glaucoma • Ophthalmology

Asymmetric Bilateral Axenfeld-Rieger Anomaly Misdiagnosed as Unilateral Iridocorneal Endothelial Syndrome. (PubMed, Cureus) - "Initial multi-drug medical intraocular pressure-lowering therapies, including the Rho kinase inhibitor ripasudil 0.4%, failed to reverse the advanced left corneal endothelial failure, ultimately necessitating a successful left penetrating keratoplasty for visual rehabilitation. This case underscores the clinical necessity of routine, thorough bilateral gonioscopic and specular evaluations of the clinically unaffected companion eye to avoid diagnostic errors when a young adult presents with sudden, highly asymmetric glaucoma."

Journal • Glaucoma • Macular Edema • Ophthalmology • Transplantation

Targeting RhoA/ROCK Signaling to Modulate Extracellular Matrix Remodeling in Corneal Endothelial Dystrophies. (PubMed, Invest Ophthalmol Vis Sci) - "Endothelial cell-Descemet membrane specimens from FECD, pseudophakous bullous keratopathy (PBK), pseudoexfoliation keratopathy (PEX-K), and normal donor corneas were treated ex vivo with ripasudil or comparator ROCK inhibitors (netarsudil, Y-27632). ROCK activation contributes to pathological ECM alterations in FECD, and its pharmacologic inhibition with ripasudil suppresses pro-fibrotic ECM production, promotes ECM-remodeling pathways, and supports restoration of ECM homeostasis. These findings suggest ROCK inhibition as a promising non-surgical therapeutic strategy for FECD and related corneal endothelial disorders, warranting further validation in preclinical studies."

Journal • Fibrosis • Immunology • Inflammation • Ophthalmology • Transplantation • CLU • RHOA • TGFB1 • TGFBI

Real-world effectiveness and safety of a fixed-dose combination of 0.4% ripasudil and 0.1% brimonidine in the management of uveitic glaucoma. (PubMed, Jpn J Ophthalmol) - "This real-world study in patients with UG showed that RBFC achieves effective IOP control while reducing treatment burden, with good tolerability, supporting its continued use in UG management."

Journal • Real-world evidence • Glaucoma • Ocular Inflammation • Ophthalmology • Uveitis

Brightening of dark trions in monolayer WS2 via localization of surface plasmons. (PubMed, J Phys Condens Matter) - "Here, we demonstrate the brightening of dark trions from ML WS2 over the temperature range, 83 K-115 K, enabled by localized surface plasmon modes in a disordered gold substrate...We also report on the negative degree of circular polarization in ML WS2 at the energy of the semi-dark trion state. Our results establish a scalable plasmonic route to access valley-polarized semi-dark trions, opening new opportunities for quantum and valleytronic applications."

Journal

Delayed Corneal Endothelial Cell Loss Following CyPass Stent Insertion: A Case Report. (PubMed, Cureus) - "We propose three areas for future research, which may explain the CECL: mechanical stress, such as from device-cornea touching; inflammation, from a chronic foreign body reaction; and direct cytotoxicity from degradation of irradiated polyimide material. Further research is needed to establish the biocompatibility of irradiated polyimide in the eye, as well as the role of ripasudil in stabilizing minimally invasive glaucoma surgery-related CECL."

Journal • Glaucoma • Inflammation • Ophthalmology

Descemet Stripping Only in Fuchs Endothelial Corneal Dystrophy: Results of a Randomized Clinical Trial of Topical Ripasudil and Directions for Future Innovation. (PubMed, Am J Ophthalmol) - "Topical K-321 given QID improves DSO outcomes, as demonstrated by a higher ECD, more rapid resolution of corneal edema and reduced failure rate. The medication was well-tolerated."

Clinical • Journal • Ophthalmology • Transplantation

Effects of Ripasudil on Mouse Subconjunctival Immune Cell Motility Activated by Monocyte Chemoattractant Protein-1. (PubMed, Invest Ophthalmol Vis Sci) - "Ripasudil attenuated MCP-1-activated macrophage behavior in both intravital imaging and in vitro experiments. These findings suggest that ripasudil may have therapeutic potential for preventing excessive wound healing after glaucoma filtering surgery."

Journal • Preclinical • Glaucoma • Ophthalmology • CCL2

Single-cell extracellular vesicle-program scoring maps immunometabolic rewiring and immune crosstalk of mesenchymal stromal cells in intervertebral disc degeneration, prioritizing AP2S1 and CSTB. (PubMed, Front Immunol) - "Docking suggested a plausible interaction between CSTB and ripasudil (-5.98 kcal/mol). This study maps an MSC EV-associated program at single-cell resolution and places it within an immune-communication and immunometabolic framework in IDD. AP2S1 and CSTB are candidate nodes linking EV-program states to immune signaling and metabolic stress, providing candidate biomarkers and tractable intervention hypotheses."

Journal • GSTP1 • IL6 • STAT3 • TSG101

Environmental context related to hydrogen sulphide and regional variation in utilisation of ROCK inhibitors in Japan: a nationwide ecological analysis. (PubMed, Sci Rep) - "Annual per-capita prescription volumes of ripasudil ophthalmic solution were obtained from the National Database of Health Insurance Claims, and geological context was quantified using the volcanic rock area ratio (VRAR) as a geological background indicator reflecting long-term environmental context, including potential exposure to H2S, rather than a direct measure of exposure...Multivariable linear regression showed limited explanatory power, whereas random forest models suggested that geological context was among the most influential predictors among the examined variables. These findings suggest that regional geological context may represent a previously underexplored structural factor associated with variation in ophthalmic prescribing patterns, highlighting a potential intersection between environmental context and population-level pharmacological utilisation."

Journal • Glaucoma • Ophthalmology • RHOA

Secondary loss of endothelial regeneration after ripasudil associated with delayed allergic contact dermatitis. (PubMed, J Fr Ophtalmol) - No abstract available

Journal • Contact Dermatitis • Dermatitis • Dermatology • Immunology

CPT1B K321 crotonylation contributes to cardiac dysfunction in endotoxic shock. (PubMed, Exp Mol Med) - "Mechanistically, LPS led to the dissociation of CBP from CPT1B, which promoted the binding of P300 to CPT1B, thereby increasing the level of CPT1B K321cr in H9C2 cells. Taken together, the results of our study revealed the regulatory axis of CPT1B K321 cr/CBP/P300 in LPS-induced endotoxic shock."

Journal • Cardiomyopathy • Cardiovascular • Metabolic Disorders • Septic Shock • CPT1B

A multi-agent system for automating scientific discovery. (PubMed, Nature) - "Robin proposed enhancing retinal pigment epithelium phagocytosis as a therapeutic strategy, and identified and confirmed in vitro efficacy for ripasudil and KL001...All hypotheses, experimental directions, data analyses, and data figures in the main text of this report were produced by Robin. As the first AI system to autonomously discover and validate novel therapeutic candidates within an iterative lab-in-the-loop framework, Robin establishes a new paradigm for AI-driven scientific discovery."

Journal • Age-related Macular Degeneration • Dry Age-related Macular Degeneration • Macular Degeneration • Ophthalmology • Retinal Disorders • ABCA1

RPE With ROCK-Mediated Epithelial-Mesenchymal Transition as a Key Contributor of Subretinal Fibrosis in AMD. (PubMed, Invest Ophthalmol Vis Sci) - "Fate-mapping with lineage tracing, laser capture microdissection, microarray and RT-PCR analyses, immunohistochemistry, and functional assays with ROCK inhibitors (Ripasudil, Belumosudil) were used to assess EMT/endothelial-to-mesenchymal transition contributions to SRF and ROCK pathway involvement. RPE-derived myofibroblasts via ROCK2-mediated EMT play a dominant role in SRF formation. ROCK inhibitors, particularly Ripasudil, may serve as effective therapeutic agents against fibrosis in nAMD."

Journal • Fibrosis • Immunology • Wet Age-related Macular Degeneration • ROCK1

A novel 0D germanium-based organic-inorganic hybrid material (C12H28N)GeCl3 showing reversible phase transition, dielectric anomaly and SHG response. (PubMed, Dalton Trans) - "The material undergoes a first-order reversible phase transition at 357 K/321 K and exhibits thermally induced reversible "on-off" SHG switching characteristics along with switchable dielectric behavior, as well as a direct band gap of 2.76 eV. This provides a new approach for the development of nonlinear optical switches, dielectric switching devices, and ultraviolet photodetectors."

Journal • TP63

Treatment Persistence with Combination Eye Drops for Glaucoma: A Longitudinal Analysis Using Japanese Medical Claims Data. (PubMed, Ophthalmol Ther) - "These findings suggest that treatment persistence with combination eye-drop therapy in Japanese patients with glaucoma or ocular hypertension may differ depending on the IOP-lowering regimen."

Journal • Cardiovascular • Glaucoma • Ophthalmology

Fibrosis suppression by ROCK inhibitors in proliferative vitreoretinopathy. (ARVO 2026) - "In addition, the RT-PCR showed only N-cadherin was suppressed by ripasudil(p<0.05), and immunostaining was same result. Conclusions In vitro, ripasudil is thought to act on cadherin, inducing changes in RPE cell morphology and thereby contributing to the suppression of PVR."

Ophthalmology • Retinal Disorders • CDH2 • S100A4 • TJP1

Rho-Kinase inhibitors promote endothelial wound healing after Descemetorhexis: a prospective, single-center, randomized, observer-blinded, placebo-controlled clinical trial (ARVO 2026) - "Conclusions Ripasudil 0.4% eye drops significantly accelerate corneal clearing as well as endothelial regeneration after Descemetorhexis. These findings support the potential clinical benefit of ROCK inhibitors to enhance corneal recovery in endothelial disorders."

Clinical • Ophthalmology

Comparison of the rho-kinase inhibitors netarsudil and ripasudil for the treatment of Fuchs endothelial corneal dystrophy (ARVO 2026) - "In long-term treatment, both medications improved features of healthy corneal cells. These results suggest that netarsudil, an already FDA-approved medication, may have potential as a medical treatment for patients with FECD."

Ophthalmology • COL8A2 • TJP1

Repeat-Dosing of Magnetic Human Corneal Endothelial Cells (EO2002) With and Without Topical Ripasudil (ARVO 2026) - P1 | "Conclusions Repeat intracameral EO2002 dosing is well tolerated in subjects with corneal edema and shows encouraging efficacy, with improvements in both BCVA and CCT. Although ripasudil produced a larger Week-32 CCT decrease, BCVA gains were similar between cohorts, indicating no added visual benefit from adjunct ripasudil."

Ophthalmology

High-spatiotemporal-resolution intravital imaging reveals ripasudil eye drops' effects on retinal circulation in an intravitreal ET-1 injection model (ARVO 2026) - "The intravital imaging revealed that intravitreal ET-1 injection decreased retinal vessel diameter and blood-cell dynamics, whereas ripasudil eye drops ameliorated both impairments. These findings suggest that ripasudil eye drops may improve retinal circulation in retinal circulatory impairment, including glaucoma."

Glaucoma • Ophthalmology • EDN1

Aqueous Column Changes in the Episcleral Veins after Instillation of a Fixed-dose Combination of Ripasudil 0.4% and Brimonidine Tartrate 0.1% (GLAALPHA) (ARVO 2026) - "Conclusions Instillation of GLAALPHA produced a significantly greater increase in aqueous column width in the episcleral veins compared with Ailamide. These findings suggest that GLAALPHA enhances aqueous outflow through the trabecular conventional pathway."

Ophthalmology

Baseline characteristics of patients enrolled in Descemet Endothelial Thickness Comparison Trial I (DETECT I) (ARVO 2026) - "We present baseline data for patients enrolled in a prospective clinical trial comparing DMEK and UT-DSAEK and investigating the effect of the rho-kinase inhibitor ripasudil on endothelial cell loss (ECL) post-operatively...This research will help determine which corneal transplant technique and post-operative medications provide patients with better vision and reduce their risk of complications. By understanding how these treatments perform in a broad, real-world group of patients, this research aims to guide surgeons toward the approaches that offer people the best chance of regaining clear, stable vision with fewer complications."

Clinical • Cataract • Glaucoma • Ocular Inflammation • Ophthalmology • Uveitis

Preoperative Use of the Rho Kinase Inhibitor Ripasudil Protects the Corneal Endothelium from Trabeculectomy-Induced Damage. (PubMed, Clin Ophthalmol) - "Among the 71 trabeculectomy+phacoemulsification+intraocular lens implantation eyes, the ripasudil group demonstrated a significantly lower mean endothelial cell density loss (0.97%) than the without-ripasudil group (7.70%) following surgery (p < 0.05). Preoperative administration of ripasudil eye drops may help maintain the functional integrity of the corneal endothelium in patients with glaucoma who underwent trabeculectomy."

Journal • Glaucoma • Ophthalmology

Effects of Ripasudil Hydrochloride Hydrate-Brimonidine Tartrate Fixed-Dose Combination Using Rho Kinase Inhibitor and Alpha2 Adrenergic Receptor Agonist on Aqueous Column in the Episcleral Vein: A Randomized, Double-Masked, Crossover Clinical Trial (ROCK Alpha-Aqua Study). (PubMed, J Clin Med) - " This single-center randomized clinical trial included healthy adult volunteers who received GLAALPHA, a brimonidine tartrate-brinzolamide fixed-dose combination (Ailamide), or brimonidine tartrate monotherapy (Aiphagan) in a crossover sequence. In healthy adult eyes, GLAALPHA significantly increased the aqueous column width in the episcleral veins 2 h after instillation, indicating enhanced conventional aqueous outflow. These findings provide evidence that GLAALPHA promotes trabecular outflow beyond the effects of brimonidine tartrate-containing comparators and offer mechanistic insights into its action."

Clinical • Journal