Failure of a compound late in development represents a lot of money wasted. Keeping these costs under control is a major concern for management. The cost per project is very much greater in the development phase, and increases sharply as the project moves into the later phases of clinical development. ĭevelopment accounts for about two-thirds of the total R&D costs.Efficiency in drug development is critical for commercial success, for two main reasons: These medications represent possible new first-line treatments or, more likely, second-line treatments in addition to or in combination with currently available PG analogues.ĭrug development comprises all the activities involved in transforming a compound from drug candidate (the end-product of the discovery phase) to a product approved for marketing by the appropriate regulatory authorities. ![]() Trabodenoson, a selective adenosine A1 receptor agonist that is thought to increase trabecular meshwork outflow facility, is also in early clinical trials. Latanoprostene bunod, a nitric oxide donating PGF 2α analogue, may have improved efficacy over latanoprost alone via nitric oxide mediated relaxation of the trabecular meshwork and Schlemm's canal. Netarsudil, a Rho kinase/norepinephrine transporter inhibitor, has been found to reduce IOP by increasing outflow facility through the expansion of the juxtacanalicular connective tissue and dilating the episcleral veins 89 and may promote retinal ganglion survival. There are seven clinical trials on Rho kinase inhibitors, including ripasudil, which relaxes contractile tone of cells within the trabecular meshwork. These medications would be the first new class of medication, if approved, since the FDA approval of latanoprost in 1996. ![]() There are several new classes of medications currently being tested in phase III clinical trials. Myron Yanoff MD, in Ophthalmology, 2019 Drug Development Pipeline
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