NCX 470 Shows Promise as Novel Glaucoma Treatment
Published: March 6, 2026
New data presented at the American Glaucoma Society (AGS) meeting suggest that NCX 470, a nitric oxide-donating bimatoprost eye drop developed by Nicox, may offer a beneficial new approach to lowering intraocular pressure (IOP) in patients with glaucoma. The findings highlight a dual mechanism of action, impacting both the trabecular meshwork and uveoscleral pathways.
Dual Mechanism of Action Confirmed
Researchers found that NCX 470 improves outflow facility and increases uveoscleral outflow, contributing to IOP reduction. A phase 3b clinical trial led by Arthur J. Sit, SM, MD, and colleagues evaluated the effects of NCX 470 on aqueous humor dynamics in 18 subjects, with four having ocular hypertension. The study, compared to a placebo control, showed a significant increase in outflow facility from baseline (0.283 ± 0.074 µL/min/mm Hg) to day 8 (0.332 ± 0.087 µL/min/mm Hg). This increase accounted for 42% of the IOP reduction observed. Uveoscleral outflow also improved, from baseline (-0.12 ± 0.83 µL/min) to day 8 (0.44 ± 0.8 µL/min), accounting for 58% of the IOP reduction. Nicox reported these findings in a press release.
DENALI Trial Results
Data from the phase 3 DENALI trial, presented by Sanjay G. Asrani, MD, compared NCX 470 with latanoprost 0.005% in 696 patients with glaucoma or ocular hypertension. The trial demonstrated noninferiority in lowering IOP compared to latanoprost, with NCX 470 showing greater IOP reduction during afternoon assessments at weeks 2 and 6. Efficacy was sustained at 3 months. Asrani noted the treatment was “safe and well tolerated with low and comparable discontinuation rates between the treatment groups.”
Subgroup Analysis Supports Findings
A subgroup analysis from the DENALI trial, detailed in a poster by Jason Bacharach, MD, and colleagues, included 549 subjects from the U.S. Mean IOP reduction in the NCX 470 group ranged from 8.1 mm Hg to 10.1 mm Hg across all time points, while the latanoprost group ranged from 7.3 mm Hg to 9.9 mm Hg. NCX 470 demonstrated better IOP reduction at multiple time points, including statistically significant differences at week 2 (8 a.m. And 4 p.m.) and week 6 (4 p.m.).
Future Outlook
Doug Hubatsch, chief scientific officer at Nicox, stated that NCX 470 could address the need for diverse and effective glaucoma treatment options. Nicox believes the clinical data validate the dual mechanism of IOP lowering and suggest potential benefits in retinal protection.
Sources/Disclosures
Source: Sit AJ, et al. Aqueous humor dynamics of NCX 470 ophthalmic solution (nitric oxide-donating bimatoprost): A double-masked, placebo-controlled, phase 3b clinical trial. Presented at: American Glaucoma Society meeting. Feb. 19-22, 2026; Rancho Mirage, California (hybrid meeting).
References: Asrani S, et al. A randomized trial comparing NCX 470 0.1%, a nitric oxide-donating bimatoprost, and latanoprost 0.005% for open-angle glaucoma or ocular hypertension: The DENALI trial. Presented at: American Glaucoma Society meeting; Feb. 19-22, 2026; Rancho Mirage, California (hybrid meeting). Bacharach J, et al. United States subgroup of the Denali trial: A randomized trial comparing NCX 470 0.1%, a nitric oxide-donating bimatoprost, and latanoprost 0.005% for open-angle glaucoma or ocular hypertension. Presented at: American Glaucoma Society meeting; Feb. 19-22, 2026; Rancho Mirage, California (hybrid meeting). Nicox highlights positive NCX 470 phase 3 data confirming therapeutic profile at the 2026 American Glaucoma Society annual meeting. https://www.nicox.com/wp-content/uploads/EN_AGS-2026-posters-presented_FINAL.pdf. Published Feb. 24, 2026. Accessed Feb. 27. 2026.
Disclosures: Asrani reports being on the advisory board for Nicox. Hubatsch reports being employed by Nicox. Sit reports that his study was supported by Nicox.