Long-term Side Effects Including Blepharitis Leading to Discontinuation of Ripasudil.

Abstract

PRECIS:

Blepharitis was the most common side effect leading to discontinuation of ripasudil therapy. Prior allergic reactions to other topical glaucoma were found to be a risk factor for ripasudil-induced blepharitis.

PURPOSE:

To report the incidence proportion of blepharitis and its relating factors due to long-term use of 0.4% riapasudil, a Rho-kinase inhibitor, in glaucoma patients of a clinical setting.

PATIENTS AND METHODS:

One hundred three eyes of 103 consecutive glaucoma patients who started ripasudil treatment between December 2014 and February 2017 at our institute, and who had a follow-up period of over 6 months were enrolled in this study. Incidence proportion, time required for recovery and risk factors associated with blepharitis and other side effects that led to discontinuation of ripasudil treatment were considered.

RESULTS:

The most frequently observed side effect was blepharitis (25.2%). The 12- and 24-month discontinuation rate due to blepharitis was 21.1%±8.2% and 34.6%±11.8% (average±SE), respectively (Kaplan-Meier analysis). Most patients recovered from blepharitis symptoms within 4 weeks, but 5 patients required over 8 weeks for recovery. Past history of allergic reactions to other topical glaucoma medication was significantly correlated with the manifestation of blepharitis (Cox proportional hazard model, P<0.007) while age, sex, intraocular pressure reduction rate, number of administered eye drops, history of systemic allergic diseases were not.

CONCLUSIONS:

Blepharitis was the most common reason for discontinuation of ripasudil treatment. Although most cases were resolved spontaneously, prolonged blepharitis was observed in a few patients. A past history of allergic reaction to other glaucoma medication indicates a higher possibility of blepharitis with ripasudil use and warrants careful administration.

• Authors: Hitomi Saito, Shinji Kagami, Koichi Mishima, Naomi Mataki, Atsuki Fukushima, Makoto Araie
• Journal: Journal of glaucoma (J Glaucoma) Vol. 28 Issue 4 Pg. 289-293 (04 2019) ISSN: 1536-481X [Electronic] United States
• PMID: 30720574 (Publication Type: Journal Article)

Chemical References

• Antihypertensive Agents
• Isoquinolines
• K-115
• Ophthalmic Solutions
• Sulfonamides
• rho-Associated Kinases

Topics

• Adult
• Aged
• Aged, 80 and over
• Antihypertensive Agents (adverse effects)
• Blepharitis (chemically induced, diagnosis)
• Edema (chemically induced, diagnosis)
• Erythema (chemically induced, diagnosis)
• Female
• Glaucoma, Open-Angle (drug therapy)
• Humans
• Intraocular Pressure (drug effects)
• Isoquinolines (adverse effects)
• Male
• Middle Aged
• Ophthalmic Solutions
• Ophthalmoscopy
• Sulfonamides (adverse effects)
• rho-Associated Kinases (antagonists & inhibitors)