Use Of Novel Immunomodulator Lifitegrast In Dry Eye Disease.

Aim of this study is to investigate the effects of 5% Lifitegrast ophthalmic solution (LTG) in improving signs and symptoms of dry eye disease (DED) along with ocular surface inflammation in patients with DED, based on the Dry eye parameters and tear biomarker profile.

Narayana Nethralaya, Bengaluru, India

Randomization was done into 22 patients receiving 5% LTG and 20 patients receiving carboxymethylcellulose 0.5 %(CMC)drops. Study followup was divided into pre and 3 months post-treatment. Patients received twice-daily doses of LTG5.0% administered as single eye drop in each eye. Schirmer’s test 1(ST1), tear film break-up time(TBUT), ocular surface disease index(OSDI), and corneal staining were studied. Tear fluid samples were collected using sterile Schirmer’s strips to study levels of interleukin(IL)-1β, IL-10, IL-6, IL-17A, tumor necrosis factor-α(TNFα), matrix metalloproteinase-9(MMP9), soluble intercellular adhesion molecule-1(sICAM1), and vascular endothelial growth factor-A(VEGF-A) using microfluidic cartridge-based multiplex ELISA.

The Lifitegrast group demonstrated a significant (P<0.05) decrease in OSDI scores along with a significant increase in Schirmer's test 1 and TBUT compared to the CMC group.  The levels of pro-inflammatory factors such as IL-1β, IL-6, IL-17A, TNFα, MMP9 and VEGF-A were also observed to be significantly reduced following treatment with LTG compared to pre-treatment levels. However, an increase in VEGF-A, a pro-inflammatory factor was observed to be increased in the post-treatment tear samples compared to pre-treatment samples in the CMC group.

Lifitegrast is a novel ICAM-1 inhibitor ophthalmic solution in the dry eye disease domain that may have a promising role in treatment refractory Dry eye disease. Significant resolution and improvement of DED signs and symptoms, along with a reduction in ocular surface inflammation as based on the Dry eye parameters and Tear film biomarkers was seen with Lifitegrast 5% drops, therefore demonstrating a promising role in Dry eye disease management.