Compound cyclosporine may be an option for the treatment of dry eye


Source / Disclosures

Disclosures: Matossian reports that she is a consultant for Allergan, ImprimisRx, Novartis and Sun Ophthalmics.

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Klarity-C was an appropriate alternative treatment for patients with dry eye, according to a study published in Clinical Ophthalmology.

Member of the board of directors of the OSN for cataract surgery Cynthia A. Matossian, MD, FACS, Recount Eye Surgery News that while therapies such as Restasis (cyclosporine 0.05%, Allergan), Xiidra (lifitegrast 5%, Novartis) and Cequa (cyclosporine 0.09%, Sun Ophthalmics) have been available for many years, some patients do not no access.

“We are fortunate to have not only more diagnostic tools to help eye care providers diagnose dry eye disease, but the emphasis is also on finding it early and actively treating it because we know the Dry eye is chronic and progressive, ”Matossian mentioned. However, “patients find it difficult to access these brand name immunomodulators. Many insurances do not cover them, the cost of the copayment is extremely high, or they have a large deductible to pay.

Cynthia A. Matossian, MD, FACS
Cynthia A. Matossian

In these situations, Matossian has stated that his drug of choice is Klarity-C (0.1% topical cyclosporin in chondroitin sulfate emulsion, ImprimisRx). She said patients can pay in cash and have it mailed directly to their homes.

“It avoids going to the pharmacy for patients, and it avoids filling out paperwork for prior authorization by senior technicians,” she said.

Matossian and his colleagues evaluated the drug in a retrospective study including 100 eyes from 50 patients with dry eye. All patients had a pre-treatment Ocular Surface Disease Index (OSDI) greater than 12 or a corneal stain grade greater than 1. Patients underwent treatment with Klarity-C twice daily for 3 months between April 2019 and July 2019.

The main study results were changes in OSDI score and corneal staining grade after 3 months of treatment from baseline. Patients were grouped according to disease severity, with an OSDI score of 0 to 12 considered normal, 13 to 22 as mild, 23 to 32 as moderate, and 33 to 100 as severe.

After 3 months, patients showed a significant improvement in mean OSDI score (38.19 vs 24.18, P P <.001 there was also a reduction in the proportion of patients with severe dry eye to while were within normal range osdi.>

The percentage of eyes with a corneal stain grade of 2 or 3 has decreased. Initially, 21% of eyes were graded 2 or 3, which decreased to 8% at 3 months. In addition, 50% of the eyes had a corneal stain grade of 0.

Klarity-C was safe and no adverse events occurred during the study. The authors hypothesized that the additional lubrication and mild anti-inflammatory effect provided by chondroitin sulfate in addition to cyclosporine could contribute to better patient comfort and improve compliance. However, they did not specifically assess the drug’s tolerance.

Matossian said the study showed that patients who have difficulty obtaining immunomodulators due to insurance issues have a good alternative to 0.1% cyclosporine in chondroitin sulfate emulsion.

“It’s a workaround if the patient’s insurance doesn’t cover other immunomodulators or if the cost is prohibitive. It’s my last resort if I can’t get the branded products, ”she said.

“There were no head-to-head trials, but as the results of our study show, it definitely demonstrated a statistically significant improvement in the various parameters that we described in the study,” said said Matossian.

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