18 months ago

Sherry • 70

@sherry

Hi, Eybelis or Omlonti eye drop was approved by FDA Sep 2022.

I checked around and didn't see it in market yet.

I heard it is pretty effective in lowering eye pressure.

Anyone knows where to get it in US?

18 months ago

david 4.2k

@david_fe

Thank you for your question. There has been an ongoing discussion in the FitEyes email list. If you are a registered member, you can login to access that discussion:

[FitEyes Discussion 46975] Re: FDA approves new glaucoma drop (OMLONTI) - All - FitEyes Discussion

I heard it is pretty effective in lowering eye pressure.

It is likely not any more effective at lowering intraocular pressure than existing prostaglandin-class glaucoma eye drops. In one study of Omlonti the mean IOP reduction was just about half a point less than latanoprost.

Here is more info from my email reply:

The active ingredient in Omlonti is a selective prostaglandin EP2 receptor agonist.

That's interesting because all the other prostaglandin-class eye drops mimic PGF2 and target a different receptor: FP.

Prostaglandins in the eye: Function, expression, and roles in glaucoma - PubMed

The currently used prostaglandin analogues (latanoprost, bimatoprost, tafluprost, and travoprost) mimic PGF2 and target one of the prostaglandin receptors (FP), though research into harnessing the other receptors ... are currently ongoing.

Below is an interesting positive finding, given that PAPS was recently raised in a discussion thread:

Changes in Prostaglandin-associated Periorbital Syndrome After Switch from Conventional Prostaglandin F2α Treatment to Omidenepag Isopropyl in 11 Consecutive Patients - PubMed

Conclusions: Some PAPS (Prostaglandin-associated Periorbital Syndrome) signs improved after patients started taking omidenepag isopropyl. Our findings will be useful for patients taking antiglaucoma eye drops.

We have some good news above and some other news below that's not quite good, but also not bad. This study of about 200 patients makes me think Omlonti may reduce IOP a bit less than latanoprost / Xalatan.

Omidenepag Isopropyl Versus Latanoprost in Primary Open-Angle Glaucoma and Ocular Hypertension: The Phase 3 AYAME Study - PubMed

The noninferiority margin for OMDI versus latanoprost was 1.5 mm Hg. At week 4, least-squares mean ± SE reduction in IOP from baseline with OMDI (-5.93 ± 0.23 mm Hg) was noninferior to that of latanoprost (-6.56 ± 0.22 mm Hg; 95% confidence interval between groups: 0.01-1.26).

The mean IOP reduction was just about half a point less than latanoprost. The study called that comparison noninferior, and many patients and their doctors may agree. But sometimes every little bit of IOP reduction helps, and I was hoping that the comparison would have gone the other way, with Omlanti having a slight edge over other prostaglandins. Oh well. It's close enough in efficacy and it's a welcome new option that may reduce certain side effects for many users.

It is already available in Japan.