Dry Eye

New Drug Approved for the Short-Term Treatment of Dry Eye Disease


Studies show significant improvement of symptoms after just two weeks

As I’ve discussed in previous posts, dry eye disease (DED) symptoms have risen during the COVID-19 pandemic. This is due to a number of factors, including the increased use of screens as more of us are working and learning remotely, as well as the wearing of ill-fitting face masks that expose the eyes to a constant flow of exhaled air. Several new treatments have been approved recently to address the growing problem of dry eye disease.

Eysuvis is the first FDA-approved ocular corticosteroid specifically for the treatment of dry eye disease.

The FDA approval of the iTear100 (Olympic Ophthalmics) neurostimulation device last summer was an exciting development. Then last October, the FDA gave the nod of approval to Eysuvis (Kala Pharmaceuticals) for the short-term treatment of signs and symptoms of DED. Eysuvis is loteprednol etabonate 0.25% with unique mucus-penetrating properties and nano-particle sized molecules. This unique formulation as well as the 0.25% concentration helped the drug achieve FDA approval. Prior to Eysuvis there were no FDA-approved ocular corticosteroids specifically for the treatment of DED.

A new way to treat dry-eye flare-ups

Eysuvis will help DED patients who experience acute flare-ups of their disease. According to a press release from Kala, based on their research 75 percent of patients have never tried a prescription therapy and only approximately 10 percent of patients are currently on a prescription dry eye medication. Kala estimates that approximately 80 percent of dry eye patients experience episodic symptoms (flares) and Eysuvius is the first FDA-approved therapeutic with a clinical profile well suited for providing fast-acting relief from these dry eye flares.

These flare-ups tend to occur about three to six times per year for many of my patients with chronic DED. It also might make a good first line therapy for those patients experiencing episodic dry eye who need rapid resolution. Eysuvis is approved for up to two weeks of treatment and is dosed QID.

Significant improvement in two weeks or less

The new drug demonstrated significant improvement in signs and symptoms based on four FDA studies. The final FDA clinical trial met both of its primary efficacy endpoints, demonstrating a statistically significant improvement in the symptom endpoint of ocular discomfort after two weeks of treatment (P=0.0002). Statistical significance was also achieved in the clinical endpoint of conjunctival hyperemia and the important finding of total corneal staining (P=0.0042). 

Although two weeks is a remarkably quick time frame for clinically significant effectiveness, the Day 8 ocular discomfort symptom improvement was also statistical (P=0.0282).

Two weeks is a remarkably quick time frame for clinically significant effectiveness.

From a safety standpoint, Eysuvis was well tolerated, with adverse events and intraocular pressure increases comparable to the placebo or vehicle. It’s exciting to see the FDA approval of a corticosteroid for the short-term treatment of both signs and symptoms of dry eye disease. We can expect to see this new pharmaceutical available for prescribing by year-end. 

Using visual patient education to explain dry eye disease

Rendia’s Exam Mode makes it easy to explain to a patient how dry eye manifests. I begin with the first image that shows the anatomy of the eyes, pointing out the lacrimal and meibomian glands, which are easily visible with Exam Mode. Although it depends on the type of dry eye, I typically zoom in on the lower lid margin for the majority of cases. I then go to Functions feature and show a normal blink and how it spreads the tears. I explain how the patient’s tears are not functioning properly due to their eyelid issues such as incomplete blink, use of digital devices, etc. I then go to Conditions and click on Dry Eye to explain what this does to the eye and the POV to show how it affects their vision. This allows me to quickly and effectively educate patients on how dry eye manifests and the consequences of this condition.

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