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Efficacy and safety of transient receptor potential channel modulators for dry eye: A systematic review and
Xiaohong Duan1, Mohan Ju2, Xinquan Liu3
1Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Purpose:
To investigate the efficacy and safety of transient receptor potential (TRP) channel modulators for dry eye.
Methods:
A thorough search for randomized clinical trials was conducted in seven databases up to February 16, 2024. Suitable studies were identified according to inclusion and exclusion criteria, extracted data were synthesized and analyzed using Review Manager 5.4, and risk of bias and quality of evidence were assessed using recommended tools.
Results:
Six trials with 884 patients using two kinds of TRP channel modulators (TRPV1 antagonist and TRPM8 agonist) were included. TRP channel modulators were effective in reducing subjective symptom scores (standardized mean differences [SMD], -0.41; 95 % confidence interval [CI], -0.75 to -0.07), corneal fluorescence staining (mean differences [MD], -0.19; 95 % CI, -0.37 to -0.02), impact on quality of life and daily function, and increasing the non-anesthetic Schirmer's test score (MD, 11.71; 95 % CI, 9.59 to 13.83), instant tear meniscus height (MD, 245.52; 95 % CI, 14.02 to 477.02), improvement in conjunctival hyperemia (risk ratio [RR], 2.08; 95 % CI, 1.07 to 4.06). There was no increased incidence of adverse events with TRP modulators compared to vehicle solution controls.
Conclusions:
TRP channel modulators have shown positive therapeutic effects in reducing the symptoms and signs of dry eye and improving the quality of life associated with the disease without raising the risk of adverse events. These modulators are expected to become a new therapy for dry eye.
Insights
Transient receptor potential (TRP) channel modulators effectively treat dry eye symptoms and signs. These novel therapies improve quality of life without increasing adverse events, offering a promising new treatment option.
Area of Science:
- Ophthalmology
- Pharmacology
- Neuroscience
Background:
- Dry eye disease (DED) is a prevalent ocular surface condition impacting millions globally.
- Current DED treatments offer limited efficacy and can have side effects.
- Transient receptor potential (TRP) channels are implicated in ocular surface sensation and inflammation.
Purpose of the Study:
- To evaluate the efficacy and safety of TRP channel modulators for treating DED.
- To synthesize evidence from randomized clinical trials (RCTs) on TRP channel modulators in DED patients.
Main Methods:
- A systematic literature search was performed across seven databases up to February 16, 2024.
- Six RCTs involving 884 patients treated with TRPV1 antagonists or TRPM8 agonists were included.
- Data analysis included synthesis of outcomes, risk of bias assessment, and quality of evidence evaluation.
Main Results:
- TRP channel modulators significantly reduced subjective symptom scores (SMD: -0.41) and corneal staining (MD: -0.19).
- Improvements were observed in quality of life, Schirmer's test scores (MD: 11.71), tear meniscus height (MD: 245.52), and conjunctival hyperemia (RR: 2.08).
- No increased incidence of adverse events was noted compared to placebo.
Conclusions:
- TRP channel modulators demonstrate significant therapeutic benefits for DED symptoms and signs.
- These agents improve patient quality of life without compromising safety.
- TRP channel modulators represent a promising new therapeutic avenue for managing dry eye disease.
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