Short Communication - (2020)Volume 11, Issue 5
Treatments for Dry Eye Disease: A Comparison Analysis
Buck F Willis*,
Justus W Thomas,
Mark C Vital and
John D Goosey
*Correspondence:
Buck F Willis, Galveston Clinical Research Foundation,
Galveston,
USA,
Email:
Author info »
Abstract
Dry eye Disease (DED) effects up to 30% of the global population (2.25 Billion people) and this inflammatory
condition of ocular surfaces has symptoms of visual disturbances, eye discomfort, tear film instability, etc. In the
United States the average cost of treating this anomaly is over $6,500 with incidence rate of up to 20 million patients.
This meeting will discuss three primary treatments of Cyclosporine 5%, Lifitegrast, and studies showing significance
and differences between these treatments. A recent Systematic Review with meta-analysis was conducted on studies of
Topical Cyclosporine 5% (Restasis®; Allergan, Inc., Irvine, CA). The 12 studies (mean 25 weeks) included 629
subjects receiving treatment of Restasis. The outcome measure shared between these studies was the Schirmer #1 test
and the mean score reduction was 2.7 mm. A retrospective case/control study was conducted, measuring efficacy of
Lifitegrast (Xiidra® Shire, Inc. Lexington, MA) versus other treatments in over 2,000 eyes. The mechanism of action
is different than Cyclosporine because Lifitegrast reduces ocular inflammation as an integrin antagonist that blocks
binding of ICAM-1 to LFA-1 on the T-cell surfaces. Testing in this investigation was accomplished with Schirmer’s
tests, Corneal staining, and tear film Break Up Time (tBUT) in different sub populations. Even with different testing
mechanisms, these Lifitegrast patients showed significant changes, particularly in short-term follow ups.
Purpose
The purpose of this meeting is to examine and discuss the
evidence-based comparisons of the current treatments for Dry
Eye Disease (DED).
Introduction
Dry eye Disease (DED) effects up to 30% of the global
population (2.25 Billion people) and this inflammatory
condition of ocular surfaces has symptoms of visual
disturbances, eye discomfort, tear film instability, etc. In the
United States the average cost of treating this anomaly is over
$6,500 with incidence rate of up to 20 million patients. This
meeting will discuss three primary treatments of Cyclosporine
5%, Lifitegrast, and studies showing significance and differences
between these treatments [1-9].
A recent Systematic Review with meta-analysis was conducted on
studies of Topical Cyclosporine 5% (Restasis®; Allergan, Inc.,
Irvine, CA) [10-14]. The 12 studies (mean 25 weeks) included 629 subjects receiving treatment of Restasis. The outcome
measure shared between these studies was the Schirmer #1 test
and the mean score reduction was 2.7 mm [15-19].
A retrospective case/control study was conducted, measuring
efficacy of Lifitegrast (Xiidra® Shire, Inc. Lexington, MA) versus
other treatments in over 2,000 eyes. The mechanism of action is
different than Cyclosporine because Lifitegrast reduces ocular
inflammation as an integrin antagonist that blocks binding of
ICAM-1 to LFA-1 on the T-cell surfaces. Testing in this
investigation was accomplished with Schirmer’s tests, Corneal
staining, and tear film Break Up Time (tBUT) in different sub
populations. Even with different testing mechanisms, these
Lifitegrast patients showed significant changes, particularly in
short-term follow ups [20-29].
Clinical Relevance
Presentation
The presentation we are proposing is a 90-minute session led by
panel of physicians and scientists. The target audience includes
physicians who treat DED [30-33]. The initial 30 minutes
presentation will include the pathological overviews of the
underlying diseases or conditions which cause DED.
• Keratoconjunctivitis Sicca
• Lacrimal gland dysfunction
• Primary aqueous tear deficiency
• Sjögren’s syndrome
• Meibomian Gland Disease, Blepharitis
• Graft host disease
• Exposure keratopathy
• Post-surgical effects (including Post-LASIK or Photorefractive
Keratectomy)
• Post-contacts lens wear
Lecturers will then discuss research on efficacy and differences
between the current treatments of Cyclosporine 5%, Lifitegrast
5%, Punctum Plugs, and other treatment methods. The topic
will discuss the differential analysis between these treatments.
Research has shown unique outcomes and differences between
the three primary treatments, including the combined therapy
of Cyclosporine with Plugs [34,35].
Prospective Funding will come from Shire Pharmaceutical and
Allergan Pharmaceutical [36-48]. The unique feature this
symposia is that it will be presented as an evidence-based
comparison of treatments and outcomes from the current
standard of care treatments for Dry Eye Disease. Our dates for
this oral presentation are flexible according to your needs.
References
- Zaman F, Thomas JW, Van DTV, Shanmugam R, Willis FB. Topical Cyclosporine 0.05% for Dry Eye Syndrome: A Systematic Review. Press Clinical Ophthalmology. 2017.
- Janine AS. The epidemiology of dry eye disease: report of the epidemiological subcommittee of the international dry eye workshop. Ocul Surf.2007;5(2):93-107.
- Žiniauskaitė A, Ragauskas S, Ghosh AK, Thapa R, Roessler AE, Koulen P, et al. Manganese (III) tetrakis (1-methyl-4-pyridyl) porphyrin, a superoxide dismutase mimetic, reduces disease severity in in vitro and in vivo models for dry-eye disease. Ocul Surf.2019;17(2):257-264.
- Abidi A, Shukla P, Ahmad A. Lifitegrast: A novel drug for treatment of dry eye disease. J Pharmacol Pharmacother.2016;7(4):194.
- Ames P, Galor A. Cyclosporine ophthalmic emulsions for the treatment of dry eye: A review of the clinical evidence. Clin Investig.2015;5(3):267-285.
- AfrozAbidi, PoojaShukla, Ali Ahmad. Lifitegrast: A novel drug for treatment of dry eye disease. J Pharmacol Pharmacother.2016;7(4):194-198.
- Brown MM, Brown GC, Brown HC, Peet J, Roth Z. Value-based medicine, comparative effectiveness, and cost-effectiveness analysis of topical cyclosporine for the treatment of dry eye syndrome. Arch Ophthalmol.2009;127(2):146-152.
- Brown MM, Brown GC, Sharma S, Landy J. Health care economic analyses and value-based medicine. Surv Ophthalmol.2003;48(2):204-223.
- Chung YW, Oh TH, Chung SK. The Effect of Topical Cyclosporine 0.05% on Dry Eye after Cataract Surgery. Korean J Ophthalmol.2013;27(3):167-171.
- Dastjerdi MH, Hamrah P, Reza D. High-frequency Topical Cyclosporine 0.05% in the Treatment of Severe Dry Eye Refractory to Twice-daily Regimen. Cornea.2009:1091-1096.
- Deveci H, Kobak S. The efficacy of topical 0.05% cyclosporine A in patients with dry eye disease associated with Sjogren’s syndrome. Int Ophthalmol.2014;34(5):1043-1048.
- Donnenfeld ED, Karpecki PM, Majmudar PA, Nichols KK, Raychaudhuri A, Roy M, et al. Safety of Lifitegrast Ophthalmic Solution 5.0% in PatientsWith Dry Eye Disease: A 1-Year, Multicenter, Randomized, Placebo-Controlled Study. Cornea.2016;35(6):741-748.
- Donnenfeld E, Pflugfelder SC. Topical ophthalmic cyclosporine: Pharmacology and clinical uses. Surv Ophthalmol.2009;54:321-338.
- Fakhraie G, Lopes JF, Spaeth GL, Almodin J, Ichhpujani P, Moster MR. Effects of postoperative cyclosporine ophthalmic emulsion 0.05% (Restasis) following glaucoma surgery. ClinExp Ophthalmol.2009;37(9):842-848.
- Fouda SM, Mattout HK. Comparison Between Botulinum Toxin A Injection and Lacrimal Punctal Plugs for the Control of Post-LASIK Dry Eye Manifestations: A Prospective Study. Ophthalmol Ther.2017;6(1):167-174.
- Godin MR, Gupta PK. Lifitegrast ophthalmic solution in the treatment of signs and symptoms of dry eye disease: design, development, and place in therapy. Clin Ophthalmol.2017;11: 951-957.
- Holland EJ, Luchs J, Karpecki PM, Nichols KK, Jackson MA, Sall K, et al. Lifitegrast for the Treatment of Dry Eye Disease: Results of a Phase III, Randomized, Double-Masked, Placebo-Controlled Trial (OPUS-3). Ophthalmology.2017;124(1):53-60.
- Holland EJ, Whitley WO, Sall K, Lane SS, Raychaudhuri A, Zhang SY, et al. Lifitegrast clinical efficacy for treatment of signs and symptoms of dry eye disease across three randomized controlled trials. Curr Med Res Opin.2016;22:1-7.
- Horn MM. Use of cyclosporine 0.05% ophthalmic emulsion for contact lens-intolerant patients. Eye Contact Lens.2006;32(2):109-111.
- Huang JF, Yafawi R, Zhang M, McDowell M, Rittenhouse KD, Sace F, et al. Immunomodulatory effect of the topical ophthalmic Janus kinase inhibitor tofacitinib (CP-690,550) in patients with dry eye disease. Ophthalmology.2012;119(7):e43-50.
- Iaccheri B, Torroni G, Cagini C, Fiore T, Cerquaglia A, Lupidi M, et al. Corneal confocal scanning laser microscopy in patients with dry eye disease treated with topical cyclosporine. Eye.2017;31(5):788-794.
- Keating GM. Lifitegrast Ophthalmic Solution 5%: A Review in Dry Eye Disease. Drugs.2017;77(2):201-208.
- Lemp MA, Crews LA, Bron AJ, Foulks GN, Sullivan BD. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: A retrospective study. Cornea.2012;31(5):472-478.
- Liew SH, Nichols KK, Klamerus KJ, Li JZ, Zhang M, Foulks GN. Tofacitinib (CP-690,550), a Janus kinase inhibitor for dry eye disease: Results from a phase 1/2 trial. Ophthalmology.2012;119(7):1328-1335.
- Methodologies to diagnose and monitor dry eye disease: Report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007). Ocul. Surf. 2007;5:108-152.
- Malta JB, Soong HK, Shtein RM, Musch DC, Rhoades W, Sugar A, et al. Treatment of ocular graft-versus-host disease with topical cyclosporine 0.05%. Cornea.2010;29(12):1392-1396.
- Park Y, Song JS, Choi CY, Yoon KC, Lee HK, Kim HS. A Randomized Multicenter Study Comparing 0.1%, 0.15%, and 0.3% Sodium Hyaluronate with 0.05% Cyclosporine in the Treatment of Dry Eye. J OculPharmacol Ther.2017;33(2):66-72.
- Paskowitz DM, Nguyen QD, Gehlbach P, Handa JT, Solomon S, Stark W, et al. Safety, tolerability, and bioavailability of topical SAR 1118, a novel antagonist of lymphocyte function-associated antigen-1: A phase 1b study. Eye.2012;26(7):944-949.
- Perry HD, Doshi-Carnevale S, Donnenfeld ED, Solomon R, Biser SA, Bloom AH. Efficacy of commercially available topical cyclosporine A 0.05% in the treatment of meibomian gland dysfunction. Cornea.2006;25(2):171-175.
- Perez VL, Pflugfelder SC, Zhang S, Shojaei A, Haque R. Lifitegrast: A novel integrin antagonist for treatment of dry eye disease.Ocul Surf.2016;14(2):207-215.
- Rao SN, Rao RD. Efficacy of topical cyclosporine 0.05% in the treatment of dry eye associated with graft versus host disease. Cornea. 2006;25(6):674-678.
- Rao SN. Topical cyclosporine 0.05% for the prevention of dry eye disease progression. J Ocul Pharmacol Ther.2010;26(2):157-164.
- Rao SN. Reversibility of dry eye deceleration after topical cyclosporine 0.05% withdrawal. J Ocul Pharmacol Ther.2011;27(6):603-609.
- Roberts CW, Carniglia PE, Brazzo BG. Comparison of topical cyclosporine, punctal occlusion, and a combination for the treatment of dry eye. Cornea.2007;26(7):805-809.
- Rubin M, Rao SN. Efficacy of topical cyclosporin 0.05% in the treatment of posterior blepharitis. J Ocul Pharmacol Ther.2006;22:47-53.
- Sall KN, Cohen SM, Christensen MT, Stein JM. An evaluation of the efficacy of a cyclosporine-based dry eye therapy when used with marketed artificial tears as supportive therapy in dry eye. Eye Contact Lens.2006;32(1):21-26.
- Sall K, Stevenson, Mundorf, Reis BL. Two multicenter, randomized studies of the efficacy and safety of cyclosporine ophthalmic emulsion in moderate to severe dry eye disease. CsA Phase 3 Study Group. Ophthalmology.2000;107:631-639.
- Schaumberg DA, Dana R, Buring JE, Sullivan DA. Prevalence of dry eye disease among US men: Estimates from the Physicians Health Studies. Arch Ophthalmol.2009;27:763-768.
- Schaumberg DA, Sullivan DA, Buring JE, Dana MR. Prevalence of dry eye syndrome among US women. Am J Ophthalmol.2003;136:318-326.
- Schirmer O. Studienzurphysiologie und pathologie der traneab-sonderung und tranenabfuhr. GraefesArchivfürKlinische und Experi-mentische Ophthalmologie.1903;56:197-291.
- Semba CP, Gadek TR. Development of lifitegrast: A novel T-cell inhibitor for the treatment of dry eye disease. Clin Ophthalmol.2016;10:1083-1094.
- Sheppard JD, Torkildsen GL, Lonsdale JD. Lifitegrast ophthalmic solution 5.0% for treatment of dry eye disease: results of the OPUS-1 phase 3 study. Ophthalmol.2014;121(2):475-483.
- Stevenson D, Tauber J, Reis BL. Efficacy and safety of cyclosporin A ophthalmic emulsion in the treatment of moderate-to-severe dry eye disease: A dose-ranging, randomized trial. The Cyclosporin A Phase 2 Study Group. Ophthalmology 2000;107:967-974.
- Su MY, Perry HD, Barsam A, Perry AR, Donnenfeld ED, Wittpenn JR, et al. The effect of decreasing the dosage of cyclosporine A 0.05% on dry eye disease after 1 year of twice-daily therapy. Cornea.2011;30(10):1098-2004.
- Sullivan BD, Crews LA, Messmer EM. Correlations between commonly used objective signs and symptoms for the diagnosis of dry eye disease: Clinical implications. Acta Ophthalmol.2014;92:161-166.
- Tauber J, Karpecki P, Latkany R. Lifitegrast ophthalmic solution 5.0% versus placebo for treatment of dry eye disease: Results of the randomized phase III OPUS-2 study. Ophthalmology.2015;122(12):2423-2431.
- Wang Y, Ogawa Y, Dogru M. Ocular surface and tear functions after topical cyclosporine treatment in dry eye patients with chronic graft-versus-host disease. Bone Marrow Transplant.2008;41(3):293-302.
- Willen CM, McGwin G, Liu B, Owsley C, Rosenstiel C. Efficacy of cyclosporine 0.05% ophthalmic emulsion in contact lens wearers with dry eyes. Eye Contact Lens.2008;34(1):43-45.
Author Info
Buck F Willis*,
Justus W Thomas,
Mark C Vital and
John D Goosey
Galveston Clinical Research Foundation, Galveston, USA
Citation: Willis BF, Thomas JW, Vital MC, Zaman F, Goosey JD (2020) Treatments for Dry Eye Disease: A Comparison Analysis. J Clin Exp
Ophthalmol. 11:857. DOI: 10.35248/2155-9570.20.11.857
Received: 11-Aug-2020
Accepted:
25-Aug-2020
Published:
01-Sep-2020
, DOI: 10.35248/2155-9570.21.11.857
Copyright: © 2020 Willis BF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.