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Expert Interview

Slingshot members are talking to an expert! The topic is:

Getting a better understanding of the AERI Glaucoma program ahead of the Rhopressa NDA filing & Roclatan 90 day data in the 3rd quarter

Ticker(s): AERI, NVS, AGN

Who's the expert?

Name: Dr David Hillman - MD

Institution: University of Illinois


  • Board-certified ophthalmologist who, in addition to his expertise in cataract, implant and laser surgery, is fellowship-trained in glaucoma.
  • In addition to private practice, Dr. Hillman is a Clinical Professor of Ophthalmology at the University of Illinois. 
  • Published a number of articles in peer reviewed journals and is a Fellow of the American Academy of Ophthalmology.

Interview Questions

How many patients do you treat with glaucoma and how do you typically treat them?

Added By: c_admin

How differentiated do you see Rhopressa vs. other Glaucoma eye drops?

Added By: c_admin

The company says the major differentiator for Rhopressa is:

"Some of the key attributes include the triple mechanism of action, including the targeting of the diseased tissue in glaucoma, the potential synergy with prostaglandin analogues (PGAs) which are the most widely prescribed first-line therapies, and the convenience of once-daily dosing. In addition, pre-clinical data suggest the potential for longer-term disease modification, the result of the anti-fibrotic effect of the drug as a Rho kinase inhibitor, as well as increased perfusion of the trabecular meshwork. In addition, we have conducted preclinical research that indicates the potential for neuroprotective attributes."

What do you make of this positioning?

  • Are these claims justified based on the data?
  • Are these claims important differentiators to you when evaluating how to treat Glaucoma patients?

Added By: c_admin

The company is developing Roclatan, a combination of Rhopressa and latanoprost. If approved the company says that this would be the only glaucoma product to cover the full spectrum of currently known IOP-lowering MOAs.  

How important is this? What types of your patients would you use this medication in if successful? 

Added By: c_admin

Rhopressa has shown either non-inferior or even superior activity to Timolol only at baseline pressures of 25 mmHg or less. What proportion of your patients fall into this range? Depending on the label, would you confine front line use to only this subset of patients (25 mmHg)?   Due to the apparent long term stable efficacy, would you use Rhopressa at higher baseline pressures in 2nd line once the effect of timolol begins to fail?

Added By: joe_mccann

Hyperemia is both the most commonly reported AE and the event most likely to lead to discontinuation of Rhopressa. Other than the aesthetic impact, how much of a concern is hyperemia for you? Have other side effects jumped out at your versus the standard of care?

Added By: joe_mccann

Can we walk through the side effect table for Rocket 1 and 2 please.  Let's discuss each rate relative to timolol and how much of a concern they are to you.


Added By: joe_mccann

Regarding hyperemia: Rhopressa will be given at night, so most of the hyperemia will occur over night. Will that heighten or lessen the impact on the patient? Will patients be more or less willing to tolerate hyperemia during their sleep hours?

Added By: zoron

 Do you find in real world that the efficacy of timolol decreases over time as the literature suggests?

Added By: joe_mccann

 Assuming both Rhopressa and Roclatan reach the market, how would you use the two products?  

Added By: joe_mccann

Currently in your practice, what is your paradigm for the first line treatment of patients and then how do you modify this as the disease progresses? How many patients do you treat?

Added By: joe_mccann

Are You Interested In These Questions?

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