Netarsudil v/s Ripasudil: The Battle of Supremacy between two ROCKS-I (Rho kinase Inhibitors)

Netarsudil v/s Ripasudil: The Battle of Supremacy between two ROCKS-I (Rho kinase Inhibitors) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Netarsudil v/s Ripasudil: The Battle of Supremacy between two ROCKS-I (Rho kinase Inhibitors) Riddhima Juneja, Taskin Khan, Vishnu Swarup Gupta, Niharika Chaudhary This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4859451/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 12 Jun, 2025 Read the published version in International Ophthalmology → Version 1 posted 9 You are reading this latest preprint version Abstract PURPOSE To compare the intraocular pressure (IOP) lowering effect and safety of topical netarsudil 0.02% once daily with topical ripasudil 0.4% twice daily in primary open angle glaucoma (POAG) patients. METHODS A prospective, comparative, randomized study conducted on 140 eyes of patients diagnosed to have POAG, in a tertiary care hospital of Northern India. Patients divided into groups, A and B in a 1:1 ratio and were treated with ripasudil 0.4% or netarsudil 0.02% respectively and followed up. The mean diurnal IOP noted at 3rd week and 3rd month comparing it from baseline values, with their side effects. RESULTS At 3rd month, mean diurnal IOP for ripasudil 0.4% group ranged from 19.22 to 20.69 mmHg whereas for netarsudil group it was 17.11 to 18.47mmHg, an intergroup statistically significant difference in IOP of 2.3mmHg (p˂0.0001) noted. At 3rd month the difference from baseline was 2.77 mmHg (p = 0.048) for ripasudil and 4.64 mmHg (p = 0.001) for netarsudil. At the end of 3 months the adverse events were seen less in group B than group A (59.8% and 66.7% respectively. Eye irritation followed by conjunctival hyperemia was seen. Overall incidence of adverse events was 32.9% and 44.3% for topical netarsudil and ripasudil respectively. CONCLUSION Topical netarsudil 0.02% once daily was well tolerated with fewer side effects and in reducing IOP than topical ripasudil 0.4% twice daily dosing in POAG patients. Netarsudil 0.02% once daily may be considered an important option for the IOP control in POAG. Primary open angle glaucoma rho-kinase inhibitors netarsudil ripasudil intraocular pressure visual analogue pain scale conjunctival hyperemia Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 12 Jun, 2025 Read the published version in International Ophthalmology → Version 1 posted Editorial decision: Revision requested 20 Apr, 2025 Reviews received at journal 14 Apr, 2025 Reviewers agreed at journal 05 Apr, 2025 Reviewers agreed at journal 02 Apr, 2025 Reviewers agreed at journal 04 Dec, 2024 Reviewers invited by journal 02 Dec, 2024 Editor assigned by journal 05 Aug, 2024 Submission checks completed at journal 05 Aug, 2024 First submitted to journal 05 Aug, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4859451","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":339603224,"identity":"9a469880-94c5-4763-9769-bd9ecc859c4e","order_by":0,"name":"Riddhima 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Inhibitors)","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"inte","sideBox":"Learn more about [International Ophthalmology](https://www.springer.com/journal/10792)","snPcode":"10792","submissionUrl":"https://submission.nature.com/new-submission/10792/3","title":"International Ophthalmology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Primary open angle glaucoma, rho-kinase inhibitors, netarsudil, ripasudil, intraocular pressure, visual analogue pain scale, conjunctival hyperemia","lastPublishedDoi":"10.21203/rs.3.rs-4859451/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4859451/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePURPOSE\u003c/h2\u003e \u003cp\u003eTo compare the intraocular pressure (IOP) lowering effect and safety of topical netarsudil 0.02% once daily with topical ripasudil 0.4% twice daily in primary open angle glaucoma (POAG) patients.\u003c/p\u003e\u003ch2\u003eMETHODS\u003c/h2\u003e \u003cp\u003eA prospective, comparative, randomized study conducted on 140 eyes of patients diagnosed to have POAG, in a tertiary care hospital of Northern India. Patients divided into groups, A and B in a 1:1 ratio and were treated with ripasudil 0.4% or netarsudil 0.02% respectively and followed up. The mean diurnal IOP noted at 3rd week and 3rd month comparing it from baseline values, with their side effects.\u003c/p\u003e\u003ch2\u003eRESULTS\u003c/h2\u003e \u003cp\u003eAt 3rd month, mean diurnal IOP for ripasudil 0.4% group ranged from 19.22 to 20.69 mmHg whereas for netarsudil group it was 17.11 to 18.47mmHg, an intergroup statistically significant difference in IOP of 2.3mmHg (p˂0.0001) noted. At 3rd month the difference from baseline was 2.77 mmHg (p\u0026thinsp;=\u0026thinsp;0.048) for ripasudil and 4.64 mmHg (p\u0026thinsp;=\u0026thinsp;0.001) for netarsudil. At the end of 3 months the adverse events were seen less in group B than group A (59.8% and 66.7% respectively. Eye irritation followed by conjunctival hyperemia was seen. Overall incidence of adverse events was 32.9% and 44.3% for topical netarsudil and ripasudil respectively.\u003c/p\u003e\u003ch2\u003eCONCLUSION\u003c/h2\u003e \u003cp\u003eTopical netarsudil 0.02% once daily was well tolerated with fewer side effects and in reducing IOP than topical ripasudil 0.4% twice daily dosing in POAG patients. Netarsudil 0.02% once daily may be considered an important option for the IOP control in POAG.\u003c/p\u003e","manuscriptTitle":"Netarsudil v/s Ripasudil: The Battle of Supremacy between two ROCKS-I (Rho kinase Inhibitors)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-30 16:07:12","doi":"10.21203/rs.3.rs-4859451/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-20T16:00:20+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-15T02:21:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"93264039002726773608536723088478953713","date":"2025-04-05T05:19:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"144036902300502236740315877749964573684","date":"2025-04-02T07:26:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"210985989365339868236175514741780175055","date":"2024-12-04T10:14:45+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-12-03T03:34:19+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-08-05T08:43:35+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-05T08:18:54+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Ophthalmology","date":"2024-08-05T05:48:50+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"inte","sideBox":"Learn more about [International Ophthalmology](https://www.springer.com/journal/10792)","snPcode":"10792","submissionUrl":"https://submission.nature.com/new-submission/10792/3","title":"International Ophthalmology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"3deb8932-4dc5-4eb4-8717-fbc7d1fec076","owner":[],"postedDate":"August 30th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-06-16T16:06:18+00:00","versionOfRecord":{"articleIdentity":"rs-4859451","link":"https://doi.org/10.1007/s10792-025-03590-7","journal":{"identity":"international-ophthalmology","isVorOnly":false,"title":"International Ophthalmology"},"publishedOn":"2025-06-12 15:57:52","publishedOnDateReadable":"June 12th, 2025"},"versionCreatedAt":"2024-08-30 16:07:12","video":"","vorDoi":"10.1007/s10792-025-03590-7","vorDoiUrl":"https://doi.org/10.1007/s10792-025-03590-7","workflowStages":[]},"version":"v1","identity":"rs-4859451","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4859451","identity":"rs-4859451","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}