Prostaglandin-associated periorbitopathy syndrome (PAPS): Addressing an unmet clinical need

Background: Topical prostaglandin analogs (PGAs) are widely approved and preferred first-line options for glaucoma and elevated intraocular pressure (IOP). However, prostaglandin-associated periorbitopathy syndrome (PAPS) is now a well-recognized clinical and cosmetic concern for patients receiving...

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Bibliographic Details
Published in:Seminars in ophthalmology 2022-05, Vol.37 (4), p.447-454
Main Authors: Sakata, Rei, Chang, Pei-Yao, Sung, Kyung Rim, Kim, Tae-Woo, Wang, Tsing-Hong, Perera, Shamira A, Cantor, Louis B
Format: Article
Language:English
Subjects:
glaucoma
Omidenepag isopropyl
PAPS
periorbitopathy
PGA
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Summary:Background: Topical prostaglandin analogs (PGAs) are widely approved and preferred first-line options for glaucoma and elevated intraocular pressure (IOP). However, prostaglandin-associated periorbitopathy syndrome (PAPS) is now a well-recognized clinical and cosmetic concern for patients receiving PGAs, especially during long-term and unilateral therapy. PGA-associated periocular changes occur in a substantial proportion of patients, with older patients (>60 years) at greater risk of clinical presentation. PAPS may hinder long-term management of glaucoma, including treatment adherence, ophthalmic surgery outcomes, and reliable IOP measurements. Recommendation: New therapeutic approaches may address this unmet clinical need. Omidenepag isopropyl (OMDI) is a novel, non-prostaglandin, selective EP 2 receptor agonist in ongoing development, which provides a unique pharmacological mechanism of action. OMDI appears to provide IOP reductions comparable to PGAs, but without PAPS-related undesirable effects. OMDI may offer a suitable long-term option for patients who demonstrate decreased efficacy, or failure, of PGAs, plus patients with significant PAPS, while fulfilling international guidelines.
ISSN:0882-0538
1744-5205
DOI:10.1080/08820538.2021.2003824