Summary of findings 3. Rho kinase inhibitor compared to prostaglandin analog.

Population: people with primary open‐angle glaucoma or ocular hypertension Settings: ophthalmology clinics Intervention: netarsudil 0.02% once per day (4 studies) Comparison: latanoprost 0.005% twice per day
Outcomes	Illustrative absolute effect (or risk)* (95% CI)		Difference (95% CI)	No. of participants (RCTs)	Certainty of the evidence (GRADE)	Comments
	With latanoprost	With netarsudil
Glaucoma progression at 12 months, measured by additional visual field defects	—	—	—	—	—	Not measured
Difference in mean IOP from baseline at < 6 months	6.44 mmHg lower (6.24 to 6.64)	5.47 mmHg lower (5.18 to 5.76)	0.97 mmHg higher (0.67 to 1.27)	1283 (4 RCTs)	⊕⊕⊕⊝ Moderatea	—
Glaucoma progression at 12 months, defined by anatomic (structural) criteriab	—	—	—	—	—	Not measured
Patient‐reported outcome at the longest follow‐up	—	—	—	—	—	Not measured
Mean change in the number of glaucoma medications at the longest follow‐up	—	—	—	—	—	Not measured
Need for additional treatment at the longest follow‐up	—	—	—	—	—	Not measured
Number of ocular adverse events at the longest follow‐up	14 events per 100 person‐months	43 events per 100 person‐months (31 to 56)	29 more events per 100 person‐months (17 to 42)	1286 (4 RCTs)	⊕⊕⊝⊝ Lowc	—
CI: confidence interval; IOP: intraocular pressure; RD: rate difference; ROKi: rho kinase inhibitor. *The basis for the assumed effect (or risk) is the effect (or risk) in the placebo group across studies. The corresponding effect (or risk and its 95% confidence interval) is based on the assumed risk in the comparison group and the difference in the effect (or risk) of the intervention (and its 95% CI).
GRADE Working Group grades of evidence High certainty: further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: we are very uncertain about the estimate.

^aDowngraded one level for risk of bias.
^bAnatomic criteria may include thinning of neuroretinal rim at the optic disk, thinning of the peripapillary retinal nerve fiber layer, or thinning of the macular ganglion cell layer.
^cDowngraded two levels for high risk of bias in selective outcome reporting and unclear bias in outcome measurement.