Improving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears

Area of Science:

• Ophthalmology
• Dry Eye Disease Research
• Ocular Therapeutics

Background:

• Dry eye disease (DED) affects millions globally, often necessitating immunomodulatory therapies.
• Lifitegrast and cyclosporine are common treatments for DED, but patient tolerance can be a challenge.
• Improving adherence to DED treatment requires strategies to enhance ocular surface comfort.

Purpose of the Study:

• To evaluate the efficacy of a micro-emulsion (ME) lipid layer artificial tear as an adjunct therapy.
• To determine if the ME artificial tear improves tolerance of immunomodulator eye drops (lifitegrast, cyclosporine) in DED patients.
• To assess the impact of the ME artificial tear on patient-reported pain scores.

Main Methods:

• A cohort of 33 DED patients received the ME lipid layer artificial tear with either lifitegrast or cyclosporine.
• Visual Analog Scale (VAS) scores were collected pre-treatment, 1 day post-instillation, and 2-3 weeks post-instillation.
• Statistical analysis compared VAS scores over time and by patient demographics and treatment timing.

Main Results:

• Mean VAS scores significantly decreased from 6.8 (pre-treatment) to 3.0 (1-day) and 1.7 (2-3 weeks) (p < 0.001).
• Improvement in VAS scores was sustained over the 2-3 week study period (p < 0.028).
• No significant differences in VAS scores were observed based on specific medication, timing, age, gender, or ethnicity.

Conclusions:

• The micro-emulsion lipid layer artificial tear significantly enhances the tolerance of lifitegrast and cyclosporine in DED patients.
• This adjunctive therapy is effective for patients at risk of, or with a history of, failing immunomodulatory treatment.
• The ME artificial tear offers a viable strategy to improve treatment adherence and outcomes in DED management.