Sakata, ReiChang, Pei-YaoSung, Kyung RimKim, Tae-WooWang, Tsing-HongPerera, Shamira A.Cantor, Louis B.2024-06-282024-06-282022Sakata R, Chang PY, Sung KR, et al. Prostaglandin-associated periorbitopathy syndrome (PAPS): Addressing an unmet clinical need. Semin Ophthalmol. 2022;37(4):447-454. doi:10.1080/08820538.2021.2003824https://hdl.handle.net/1805/41968Background: 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 EP2 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.en-USAttribution-NonCommercial-NoDerivatives 4.0 InternationalOmidenepag isopropylPAPSPGAGlaucomaPeriorbitopathyArticle