Therapeutic uses of prostaglandin F2α analogues in ocular disease and novel synthetic strategies

The pharmacological management of glaucoma and ocular hypertension has significantly changed over the last 18 years with the introduction of PGF(2 alpha), analogues, more specifically latanoprost (6), travoprost (8), bimatoprost (10) and tafluprost (12). Prostanoids are currently the first-line medicines among ocular antihypertensive drugs in terms of efficacy, safety, patient compliance and medical economy. Their ability to effectively reduce intraocular pressure with once-per-day dosing, ocular tolerability comparable to timolol and general lack of systemic adverse effects have made them the mainstay of pharmacological therapy for glaucoma and ocular hypertension all over the world. The present review reports a novel, convergent and highly diastereoselective method for the synthesis of PGF(2 alpha), analogues from the structurally advanced prostaglandin phenylsulfone (5Z)-(+)-15 and new omega-chain synthons. The biochemistry, clinical efficacy and side effects of four commercially available PGF(2 alpha), analogues, currently used as firstline agents for reducing intraocular pressure in patients with glaucoma or ocular hypertension, are also discussed. (C) 2013 Elsevier Inc. All rights reserved.