Rhopressa (netarsudil) / Alcon - LARVOL DELTA

Netarsudil-Induced Honeycomb Keratopathy in an Eye With Iridocorneal Endothelial Syndrome. (PubMed, Case Rep Ophthalmol Med) - "Endothelial cell dysfunction in ICE syndrome may be a risk factor for patients to develop reversible netarsudil-induced honeycomb keratopathy. Ophthalmologists should exercise caution when prescribing netarsudil for glaucoma management in patients with pre-existing corneal pathologies, including those with ICE syndrome."

Journal • Glaucoma • Ophthalmology

Intraocular Pressure-Lowering Effect of Netarsudil Across Glaucoma Severity. (PubMed, J Glaucoma) - "Netarsudil was associated with a significant IOP-lowering effect across all stages of glaucoma, without significant differences according to disease severity. However, the durability of its effect may be influenced by systemic hypertension, suggesting the need for closer monitoring in hypertensive patients."

Journal • Cardiovascular • Glaucoma • Hypertension • Ophthalmology

The Effect of Topical Rho-kinase Inhibitors on Corneas of Patients With Fuchs Endothelial Corneal Dystrophy (clinicaltrials.gov) - P=N/A | N=50 | Enrolling by invitation | Sponsor: University Hospital Dubrava | Trial primary completion date: Apr 2026 ➔ Dec 2026

Trial primary completion date • Cataract • Glaucoma • Ophthalmology • Transplantation

METTL7B Mitigates Hypertension and Vascular Remodeling. (PubMed, Circulation) - "Finally, the Food and Drug Administration-approved drug netarsudil exerted preventive and therapeutic effects on hypertension and vascular remodeling by activating METTL7B; notably, these therapeutic benefits were completely abolished in VSMC-specific Mettl7b knockout mice...The METTL7B-HNRNPH1-FILIP1L axis mitigates hypertension by regulating VSMC dedifferentiation and vascular tone. Targeted activation of METTL7B may emerge as a promising strategy for hypertension."

Journal • Cardiovascular • Hypertension • HNRNPH1 • KLF4 • METTL3

Global landscape and thematic evolution of glaucoma pharmacotherapy research (1996-2025): A bibliometric and science mapping analysis. (PubMed, Int Ophthalmol) - "The research on pharmacotherapy of glaucoma expanded at a rapid pace since 2018 and was still focused in a limited number of countries and journals. The citation influence was dominated by landmark clinical evidence, and the thematic focus relocated to long-term use, tolerability, and delivery innovation. The future research can be directed at the enhancement of persistence, ocular protection, and scalable sustained delivery strategies that decrease the number of daily drops."

Journal • Review • Glaucoma • Ophthalmology

Preparation of a new fixed-combination carteolol-netarsudil ophthalmic solution via one-pot pH-adjusting solubilization strategy for glaucoma treatment. (PubMed, Drug Deliv) - "Importantly, once daily, FC-CN-TKN exerted a potent IOP-lowering effect and protective effect on retinal ganglion cells. The innovative FC-CN-TKN was stable, safe, and effective, being a promising glaucoma therapy."

Journal • Glaucoma • Ophthalmology

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

Pilot Clinical Trial of Topical Netarsudil to Lower Risk of Proliferative Vitreoretinopathy in High-Risk Primary Retinal Detachment. (PubMed, J Vitreoretin Dis) - P2/3 | "Median logMAR (Snellen equivalent) visual acuity in the netarsudil vs placebo arm was 1.24 (20/350) vs 1.35 (20/450) at baseline (P = .87), 0.7 (20/100) vs 0.48 (20/60) at month 3 (P = .27), and 0.48 (20/60) vs 0.54 (20/70) at month 6 (P = .91). Treatment of eyes with primary RRD at high risk for PVR with netarsudil 0.02% once daily for 8 weeks after PPV with or without scleral buckling did not appear to affect PVR redetachment or visual outcomes compared with placebo."

Clinical • Journal • Hematological Disorders • Retinal Disorders

Drug-associated lacrimal drainage obstruction: a population-based pharmacovigilance study. (PubMed, Orbit) - "Sodium iodide I-131 (ROR = 399.7, 95%CI=[262.8, 608.0]), netarsudil (ROR = 350.6, 95%CI=[242.7, 506.5]) and docetaxel (ROR = 168.7, 95%CI=[145.8, 195.3]) showed the highest disproportionate reporting of lacrimal drainage obstruction-related AEs. Clinician awareness is important, particularly for patients at elevated risk. Further research is needed to clarify causality and inform prevention strategies."

Adverse events • Journal • Ophthalmology

Discovery of novel ROCK inhibitors RX-021 and RX-044 with intraocular pressure-lowering effect for glaucoma treatment. (PubMed, Eur J Med Chem) - "In a mouse ocular hypertension model, RX-021 achieved superior IOP reduction (5.38 ± 1.51 mmHg at 4 h) versus (S)-Netarsudil, with sustained 24 h efficacy and reversible HTM cell effects...Slit-lamp exams confirmed that initial ocular irritation subsided with extended dosing. These findings establish RX-021 and RX-044 as promising novel ROCK inhibitors with enhanced IOP-lowering efficacy and good retinal protective effects for glaucoma therapy."

Journal • Cardiovascular • Glaucoma • Ophthalmology

Longitudinal Structural and Functional Trajectories Following Netarsudil Intensification or Surgical Escalation in Primary Open-Angle Glaucoma. (PubMed, Semin Ophthalmol) - "During follow-up, 27% of eyes in the netarsudil group required subsequent surgical escalation. Although surgery achieved greater IOP reduction, short-term structural and functional trajectories remained similar after treatment escalation over 12 months."

Journal • Glaucoma • Ophthalmology

The Effect of ROCK Inhibitors on Corneas of Patients With Glaucoma and Pseudophakic Bullous Keratopathy (PBK) (clinicaltrials.gov) - P2/3 | N=50 | Completed | Sponsor: University Hospital Dubrava | Enrolling by invitation ➔ Completed | Phase classification: P ➔ P2/3 | Trial completion date: Oct 2026 ➔ May 2026

Phase classification • Trial completion • Trial completion date • Glaucoma • Ophthalmology

The effects of netarsudil ophthalmic solution on the expression of genes involved in fibrogenesis in orbital fibroblasts of patients with thyroid eye disease. (PubMed, Mol Biol Rep) - "Our findings suggest that non-cytotoxic dose of netarsudil, is insufficient to reverse the constitutively pro-fibrotic transcriptional program in TED orbital fibroblasts. The lack of direct antifibrotic efficacy highlights the complexity of TED fibrogenesis and suggests that redundant or parallel signaling pathways may limit the impact of isolated ROCK inhibition. Further research is required to evaluate combination therapies or alternative targets in TED-related fibrosis."

Journal • Fibrosis • Immunology • Ophthalmology • Thyroid Eye Disease • CTNNB1 • RHOA • TGFB1 • THY1 • ZEB1

Prognostic factors associated with visual field recovery in non-arteritic anterior ischemic optic neuropathy. (PubMed, PLoS One) - "No significant association was observed between topical eye drop treatment, including brimonidine and netarsudil, and visual field recovery (p = 0.723). However, RNFL thickness measured at initial visit by OCT did not reliably predict recovery. These findings highlight that baseline functional status remain as the most important predictor of visual field recovery in NAION."

Biomarker • Journal • Ocular Inflammation • Ophthalmology • Optic Neuritis • Pain

Quantitative prediction of siRNA complexation by ionizable drugs enables their codelivery in nanoparticles. (PubMed, Sci Adv) - "Netarsudil was predicted to encapsulate siRNA at high efficiency and was thus tested experimentally with siRNA targeting connective tissue growth factor (CTGF) in fibrotic human trabecular meshwork cells: Reduced CTGF mRNA expression and actin network density were observed. These predictive tools may unlock combination therapies."

Journal • Fibrosis • CTGF

Imaging the Effects of Netarsudil (Rhopressa) on the Trabecular Meshwork in Glaucoma and Ocular Hypertension (clinicaltrials.gov) - P4 | N=50 | Recruiting | Sponsor: Indiana University | Not yet recruiting ➔ Recruiting

Enrollment open • Cardiovascular • Glaucoma • Ophthalmology

Effect of Rhopressa on Intraocular Pressure (IOP) in Patients With Primary Open-Angle Glaucoma or Ocular Hypertension Post-SLT (clinicaltrials.gov) - P4 | N=70 | Active, not recruiting | Sponsor: East Coast Institute for Research | Recruiting ➔ Active, not recruiting | Trial completion date: Apr 2026 ➔ Sep 2026 | Trial primary completion date: Apr 2026 ➔ Jul 2026

Enrollment closed • Trial completion date • Trial primary completion date • Cardiovascular • Glaucoma • Ophthalmology

Rho-Kinase Inhibitor-A Molecule for Pharmacological Treatment of Decompensated Corneas: Case Series. (PubMed, Biomedicines) - "The aim of this study was to evaluate changes in central corneal thickness (CCT), best-corrected visual acuity (BCVA), and treatment-related adverse events in eyes with corneal edema of different etiologies treated with fixed-combination drops of netarsudil 0.02%/latanoprost 0.005%, Roclanda®. These exploratory findings cannot explain the mechanism of action, but suggest a potential therapeutic role for ROCK inhibitors in eyes with nonhealing corneal edema and possibly residual endothelial reserve. Larger controlled studies are needed to confirm these observations and further define indications for treatment."

Journal

Investigating therapeutic response to netarsudil in glaucoma subjects with the ARHGEF12 risk variant. (PubMed, Front Pharmacol) - "These results should therefore be considered exploratory. Future studies with larger, treatment-naïve cohorts are needed to evaluate pharmacogenetic associations."

Journal • Glaucoma • Ophthalmology • RHOA

Rocklatan vs Latanoprost Post-DSLT (clinicaltrials.gov) - P4 | N=36 | Recruiting | Sponsor: Eye Centers of Southeast Texas | Not yet recruiting ➔ Recruiting

Enrollment open • Monotherapy • Glaucoma • Ophthalmology

Efficacy of Netarsudil in Open and Closed Angle Glaucomas Within the Vietnamese Population: A Single-Center, Retrospective Study. (PubMed, Clin Ophthalmol) - "A retrospective chart review was performed of eyes diagnosed with OAG, CMG, or ACG and treated with netarsudil (Rhopressa or Rocklatan) between 2018 and 2024 at a single glaucoma specialty clinic in San Jose, California. Netarsudil and its combination therapies demonstrated no significant difference in IOP reduction and tolerability across OAG, CMG, and ACG. These findings support its use as an adjunctive therapy regardless of angle configuration and highlight the need for prospective studies in Asian populations."

Journal • Retrospective data • Glaucoma • Ophthalmology

Efficacy and safety of netarsudil compared with prostaglandin-based therapies: a Bayesian network meta-analysis. (PubMed, Int Ophthalmol) - "The study aimed to compare the efficacy and safety of netarsudil (NET), alone or in fixed-dose combinations (FDC), in comparison with prostaglandin analogues (PGAs: bimatoprost [BIM], latanoprost [LAT], travoprost [TRA], and tafluprost [TAF]) for the treatment of primary open-angle glaucoma (POAG) or ocular hypertension. Although NET ranked lower in IOP-lowering efficacy compared to most PGAs and FDC, it demonstrated a favorable safety profile, particularly with a relatively lower incidence of conjunctival hyperemia than TAF and FDC. These findings suggest that NET may serve as a valuable alternative in patients who are intolerant to PGAs or require adjunctive therapy, warranting further investigation in targeted populations."

Clinical • Journal • Retrospective data • Cardiovascular • Glaucoma • Ophthalmology

Persistent Epithelial Defect After Bullae Rupture With Netarsudil. (PubMed, Cureus) - "Ophthalmologists should be cognizant of the potential corneal adverse effects associated with netarsudil, including REE and bullae formation. In cases of persistent epithelial defects, underlying predisposing factors should be carefully evaluated and managed appropriately."

Journal • Glaucoma • Ophthalmology • Transplantation

Re-Purposing a Rho-Associated Coiled-Coil Kinase (ROCK) Inhibitor for Alzheimer's Disease. (PubMed, J Clin Med) - "The exploratory proteomic analysis of mouse brains exposed to netarsudil revealed changes in mitochondrial function, enrichment of metallothioneins Mt1 and Mt2, and suppression of the AD-related genes Pzp and Serpina3m. The apparent reduction in AD pathological protein tau/ptau and a neuroprotective proteomic profile in vivo suggest the potential for netarsudil to be developed as a new AD therapeutic agent."

Journal • Alzheimer's Disease • CNS Disorders • p-tau181 • SERPINA3

Imaging the Effects of Netarsudil (Rhopressa) on the Trabecular Meshwork in Glaucoma and Ocular Hypertension (clinicaltrials.gov) - P4 | N=50 | Not yet recruiting | Sponsor: Indiana University

New P4 trial • Cardiovascular • Glaucoma • Ophthalmology