Topical eye drops—predominantly prostaglandins—have long been the go-to treatment for reducing intraocular pressure (IOP) and attempting to slow or prevent vision loss in patients with glaucoma. The newest prostaglandin to join the line-up, called Omlonti (omidenepag isopropyl 0.002%), features a unique mechanism of action that makes it the first relatively selective prostaglandin EP2 receptor agonist marketed in the US, according to manufacturer Santen and its partner UBE Corp. The drug has been sold in several regions of Asia since 2018. Omlonti works by increasing aqueous humor drainage through both the trabecular and uveoscleral outflow pathways, according to its developers. Recommended dosing is once daily at bedtime.

The safety and efficacy of Omlonti were evaluated in three randomized controlled clinical trials involving patients with open-angle glaucoma or elevated IOP with an average baseline IOP of 24mm Hg to 26mm Hg. Over three months, IOP lowered on average by 5mm Hg to 7mm Hg for those taking Omlonti (for study participants who received timolol or latanoprost, the average IOP reduction was 5mm Hg to 7mm Hg and 6mm Hg to 8mm Hg, respectively). 

With glaucoma being among the most common causes of vision loss worldwide, it’s encouraging to both patients and providers to see the continual development of novel approaches to control IOP and reduce the impact of the disease.

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