Evaluating the novel application of cyclosporine 0.1% in ocular surface disease

ABSTRACT

Introduction: Ocular surface disease (OSD) is a highly prevalent symptomatic condition caused by dry eye disease (DED), intrinsic, environmental, or iatrogenic causes. It affects patient’s visual function and quality of life. Its pathophysiology is centered on tear hyperosmolarity, inflammation, and epithelial damage. Current management is suboptimal and includes artificial tear supplementation and short-term use of topical steroids in severe cases. The recent approval of cyclosporine 0.1% has transformed management strategies of severe DED and moderate-to-severe OSD.

Areas covered: This review summarizes existing information on the efficacy, safety, and tolerability of the new cyclosporine 0.1% formulation.

Expert opinion: Topical cyclosporine A 0.1% represents a promising, novel medication for the management of DED, Meibomian gland dysfunction, and inflammatory OSD. It is primarily beneficial for those patients requiring topical immunomodulatory therapy. This topical formulation also has the potential to meaningfully improve the management of moderate-to-severe glaucoma therapy-related OSD. Currently there is limited published clinical data concerning the efficacy of topical cyclosporine. There are, however, theoretical advantages when comparing this cyclosporine formulation with other established commercial preparations. Future research is needed to delineate the precise role and value of this medication.

KEYWORDS:

• Cationic emulsion
• dry eye disease
• DED
• cyclosporine 0.1%
• CsA
• glaucoma
• Ikervis
• immunomodulation
• ocular surface disease
• OSD
• ocular inflammation
• T-cells

Declaration of interest

KG Boboridis has received honoraria for lectures and travelling support from Allergan, Thea Pharmaceuticals, Santen Pharmaceutical Co. Ltd., Mundipharma and Vianex. AGP Konstas has received honoraria for lectures and travelling support from Allergan, Bayer Healthcare, Mundipharma, Santen Pharmaceutical Co. Ltd and Vianex as well research funding from Allergan, Novartis and Santen Pharmaceutical Co. Ltd. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. One referee declares that they are a consultant for Allergan, Novartis, Thea Pharmaceuticals and Santen Pharmaceutical Co. Ltd. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Box 1. Drug summary box

Additional information

Funding

This manuscript was supported in part by Santen Pharmaceutical Co. Ltd.