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Gupta PK, Toyos R, Sheppard JD, Toyos M, Mah FS, Bird B, Theriot PE, Higgins D. Tolerability of Current Treatments for Dry Eye Disease: A Review of Approved and Investigational Therapies. Clin Ophthalmol 2024; 18:2283-2302. [PMID: 39165367 PMCID: PMC11334916 DOI: 10.2147/opth.s465143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/06/2024] [Indexed: 08/22/2024] Open
Abstract
Dry eye disease (DED) is a common, multifactorial ocular disease impacting 5% to 20% of people in Western countries and 45% to 70% in Asian countries. Despite the prevalence of DED and the number of treatment approaches available, signs and symptoms of the disease continue to limit the quality of life for many patients. Standard over-the-counter treatment approaches and behavior/environmental modifications may help some cases but more persistent forms often require pharmacological interventions. Approved and investigational pharmaceutical approaches attempt to treat the signs and symptoms of DED in different ways and tend to have varying tolerability among patients. While several pharmacological approaches are the standard for persistent and severe disease, mechanical options provide alternate treatment modalities that attempt to balance efficacy and comfort. Newer approaches target the causes of DED, utilizing novel delivery methods to minimize irritation and adverse events. Here, we review approved and investigational approaches to treating DED and compare patient tolerability.
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Affiliation(s)
- Preeya K Gupta
- Triangle Eye Consultants, Raleigh, NC, USA
- Department of Ophthalmology, Tulane University, New Orleans, LA, USA
| | | | | | | | | | - Brian Bird
- Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA, USA
| | | | - Don Higgins
- Dry Eye Treatment Center of Connecticut, Plainville, CT, USA
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Juan C, Qi W, Min Y, Boping W, Weixun L, Xingxiang L, Xiaorong H, Xiao K, Daiguo Z. An LC-MS/MS method for the determination of Lifitegrast in human plasma and tear and its application in the pharmacokinetic study. Bioanalysis 2024; 16:535-544. [PMID: 39088034 PMCID: PMC11299789 DOI: 10.1080/17576180.2024.2344345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/15/2024] [Indexed: 08/02/2024] Open
Abstract
Aim: A new, selective and simple UPLC-MS/MS method was developed and validated for the determination of lifitegrast in human plasma and tear in order to obtain PK data. Materials & methods: Lifitegrast-d4 solutions were added in the samples, and then were extracted and transferred to a UPLC vial. Results: The respective working ranges were 25.00-2000.00 pg/ml in plasma and 4.00-1000.00 μg/ml in tear. The fully validated method complied with existing regulatory criteria for accuracy and precision, recovery, etc. It was applied to plasma and tear samples, which were from a clinical study, successfully. Conclusion: This method is useful in the evaluation of lifitegrast in plasma and tear.
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Affiliation(s)
- Cai Juan
- Sichuan Institute for Drug Control, Chengdu, 611731, China
| | - Wen Qi
- Sichuan Institute for Drug Control, Chengdu, 611731, China
| | - Yang Min
- Sichuan Institute for Drug Control, Chengdu, 611731, China
| | - Wei Boping
- Sichuan Institute for Drug Control, Chengdu, 611731, China
| | - Lv Weixun
- Chengdu Kanghong Pharmaceutical Co. Ltd, Chengdu, 610037, China
| | - Lv Xingxiang
- Chengdu Kanghong Pharmaceutical Co. Ltd, Chengdu, 610037, China
| | - He Xiaorong
- Chengdu Kanghong Pharmaceutical Co. Ltd, Chengdu, 610037, China
| | - Ke Xiao
- Chengdu Kanghong Pharmaceutical Co. Ltd, Chengdu, 610037, China
| | - Zhao Daiguo
- Sichuan Institute for Drug Control, Chengdu, 611731, China
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Kim E, Jang E, Jung W, Kim W, Lee J, Choi DH, Shin BS, Shin S, Kim TH. Establishment of an LC-MS/MS method for quantification of lifitegrast in rabbit plasma and ocular tissues and its application to pharmacokinetic study. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1229:123892. [PMID: 37788538 DOI: 10.1016/j.jchromb.2023.123892] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023]
Abstract
Lifitegrast, a lymphocyte function-associated antigen 1 antagonist, was approved by the FDA for the treatment of dry eye disease. Cornea and conjunctiva have been reported to be the sites of action of lifitegrast. To investigate the pharmacokinetics of lifitegrast, a sensitive analytical method for the determination of lifitegrast in various biological matrices such as plasma and ocular tissues is required. However, only limited information about the analytical method for lifitegrast in biological samples is available. In the present study, we aimed to develop a new liquid chromatography-tandem mass spectrometry method for the determination of lifitegrast in rabbit plasma, cornea, conjunctiva, and sclera. Lifitegrast-d6 was used as an internal standard (IS). To prepare the biological samples, protein precipitation using acetonitrile was utilized. Analytes were separated from endogenous interferences on an Atlantis dC18 (5 µm, 2.1 × 150 mm), and a mixture of 0.1 % formic acid and acetonitrile was used as the mobile phase. The mass transition of precursor to product ion was monitored at 615.2 → 145.0 for lifitegrast and 621.2 → 145.1 for IS. The calibration curves were linear over the concentration range from 2 to 500 ng/mL for plasma and 5 to 500 ng/mL in ocular tissue homogenates. Intra- and inter-day accuracy ranged from 95.76 to 106.80 % in the plasma and 94.42 to 112.80 % in the ocular tissues. Precision was within 8.56 % in the plasma and 9.72 % in the ocular tissues. The short-term, long-term, auto-sampler, and freeze-thaw stabilities of lifitegrast were validated. The developed method was applied to a pharmacokinetic study of lifitegrast in rabbits. Following ophthalmic administration, only 3.26 % of administered lifitegrast was absorbed into the systemic circulation. Peak tissue concentrations were observed at 0.5 h after dosing, and topically administered lifitegrast was mainly distributed in the cornea and conjunctiva. The finding of this study is expected to be used in further pharmacokinetic studies and formulation development.
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Affiliation(s)
- Eunbin Kim
- College of Pharmacy, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Eunbee Jang
- College of Pharmacy, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Woohyung Jung
- College of Pharmacy, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Woojin Kim
- College of Pharmacy, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Jaewoong Lee
- College of Pharmacy, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Du Hyung Choi
- College of Pharmacy, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Beom Soo Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi, Korea
| | - Soyoung Shin
- College of Pharmacy, Wonkwang University, Iksan, Jeonbuk, Korea.
| | - Tae Hwan Kim
- College of Pharmacy, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea.
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Shen Lee B, Toyos M, Karpecki P, Schiffbauer J, Sheppard J. Selective Pharmacologic Therapies for Dry Eye Disease Treatment: Efficacy, Tolerability, and Safety Data Review from Preclinical Studies and Pivotal Trials. Ophthalmol Ther 2022; 11:1333-1369. [PMID: 35608780 PMCID: PMC9253213 DOI: 10.1007/s40123-022-00516-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
Keratoconjunctivitis sicca, also known as dry eye disease (DED), is a prevalent, multifactorial disease associated with compromised ocular lubrication, ocular surface inflammation and damage, and ocular symptoms. Several anti-inflammatory, topical ophthalmic therapies are available to treat clinical signs and symptoms of DED in the USA and Europe. Cyclosporine A (CsA)-based formulations include an ophthalmic emulsion of 0.05% CsA (CsA 0.05%), a cationic emulsion (CE) of CsA 0.1% (CsA CE), and an aqueous nanomicellar formulation of 0.09% CsA (OTX-101). Lifitegrast is a 5% ophthalmic solution of a lymphocyte function-associated antigen 1 antagonist that is believed to target T cell activation and recruitment to inhibit ocular inflammation. Here we provide a comprehensive review summarising preclinical studies and pivotal trial data for these treatments to provide a complete understanding of their efficacy and safety profile. Overall, data in the evaluated studies show a favourable risk-benefit profile for the use of targeted topical anti-inflammatory pharmacologic treatments in patients with DED. Pivotal trials for CsA 0.05%, CsA CE, OTX-101, and lifitegrast clearly demonstrate treatment efficacy compared to vehicle across treatments with no serious ocular treatment-emergent adverse events (TEAEs). Patients using ophthalmic treatments reported ocular TEAEs more frequently than those treated with vehicle; however, relatively few TEAEs led to treatment discontinuation. The specific signs and symptoms of DED that improve with treatment vary with the treatment prescribed. Long-term and direct comparative studies between treatments are needed to further understand treatment differences in efficacy and safety profiles.
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Affiliation(s)
| | | | - Paul Karpecki
- Kentucky Eye Institute, Lexington, KY, USA
- University of Pikeville Kentucky College of Optometry, Pikeville, KY, USA
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Comparative evaluation of once-daily and twice-daily dosing of topical bromfenac 0.09%: aqueous pharmacokinetics and clinical efficacy study. J Cataract Refract Surg 2021; 47:1115-1121. [PMID: 34468447 DOI: 10.1097/j.jcrs.0000000000000589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate aqueous pharmacokinetics of topical bromfenac 0.09% and compare clinical outcomes of once- and twice-daily dosing in phacoemulsification. SETTING Dr. R.P. Center for Ophthalmic Sciences, AIIMS, New Delhi, India. DESIGN Prospective interventional study. METHODS In phase I, single-drop aqueous pharmacokinetics of topical bromfenac was estimated at 15 minutes, 30 minutes, 1 hour, 2 hours, 4 hours, 12 hours, and 24 hours using liquid chromatography mass spectrometry in 60 eyes. In phase II, 45 eyes undergoing phacoemulsification were enrolled: group I (control, n = 15), group II (once-daily bromfenac, n = 14), and group III (twice-daily bromfenac, n = 16). Intraoperative pupillary miosis, postoperative anterior chamber (AC) flare, Summed Ocular Inflammation Score (SOIS), central macular thickness (CMT), and pain scores were assessed. Follow-up was performed at 1 day, 7 days, 28 days, and 90 days postoperatively. RESULTS Half-life of topical bromfenac was 3.6 hours, mean residence time 5.5 hours, and peak concentration (63.73 ng/mL) achieved after 2 hours. Aqueous concentration was more than inhibitory concentration (IC50) at 12 hours but not at 24 hours. Cumulative effect was observed with repeated dosing with aqueous levels more than IC50 in once-daily and twice-daily groups at 5 days. Significant intraoperative miosis was observed in group I. Pain score, AC flare, and SOIS were significantly more in group I (P < .001) and comparable in groups II and III at all timepoints. CMT was comparable in all groups; no case developed cystoid macular edema. CONCLUSIONS Single-dose topical bromfenac did not maintain therapeutic aqueous concentration over 24 hours; however, cumulative effect was observed with repeated dosing. Clinical efficacy of once-daily and twice-daily dosing was comparable.
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Krstić L, González-García MJ, Diebold Y. Ocular Delivery of Polyphenols: Meeting the Unmet Needs. Molecules 2021; 26:molecules26020370. [PMID: 33445725 PMCID: PMC7828190 DOI: 10.3390/molecules26020370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 12/14/2022] Open
Abstract
Nature has become one of the main sources of exploration for researchers that search for new potential molecules to be used in therapy. Polyphenols are emerging as a class of compounds that have attracted the attention of pharmaceutical and biomedical scientists. Thanks to their structural peculiarities, polyphenolic compounds are characterized as good scavengers of free radical species. This, among other medicinal effects, permits them to interfere with different molecular pathways that are involved in the inflammatory process. Unfortunately, many compounds of this class possess low solubility in aqueous solvents and low stability. Ocular pathologies are spread worldwide. It is estimated that every individual at least once in their lifetime experiences some kind of eye disorder. Oxidative stress or inflammatory processes are the basic etiological mechanisms of many ocular pathologies. A variety of polyphenolic compounds have been proved to be efficient in suppressing some of the indicators of these pathologies in in vitro and in vivo models. Further application of polyphenolic compounds in ocular therapy lacks an adequate formulation approach. Therefore, more emphasis should be put in advanced delivery strategies that will overcome the limits of the delivery site as well as the ones related to the polyphenols in use. This review analyzes different drug delivery strategies that are employed for the formulation of polyphenolic compounds when used to treat ocular pathologies related to oxidative stress and inflammation.
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Affiliation(s)
- Luna Krstić
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; (L.K.); (M.J.G.-G.)
| | - María J. González-García
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; (L.K.); (M.J.G.-G.)
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Yolanda Diebold
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; (L.K.); (M.J.G.-G.)
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-883423274
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Haber SL, Benson V, Buckway CJ, Gonzales JM, Romanet D, Scholes B. Lifitegrast: a novel drug for patients with dry eye disease. Ther Adv Ophthalmol 2019; 11:2515841419870366. [PMID: 31489402 PMCID: PMC6710705 DOI: 10.1177/2515841419870366] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/26/2019] [Indexed: 11/17/2022] Open
Abstract
The objective of this article is to review the pharmacology, efficacy, and safety of lifitegrast and determine its role relative to other agents in the management of dry eye disease. A PubMed search (1946 to December 2018) using the terms lifitegrast and SAR 1118 was conducted to identify relevant articles. In vitro or in vivo evaluations of lifitegrast published in the English language were eligible for inclusion. Phase II and III trials were selected for review of efficacy and safety. Four randomized controlled trials evaluated the efficacy and safety of lifitegrast 0.5% ophthalmic solution for 12 weeks, and 1 additional trial assessed safety for 1 year. In a majority of the trials, lifitegrast caused statistically significant improvements in inferior corneal fluorescein staining scores and eye dryness scores. The most common adverse effects were eye irritation, dysgeusia, and reduced visual acuity, and most were mild to moderate in severity. Lifitegrast has a novel mechanism of action and is safe and effective for the treatment of dry eye disease. At this time, lifitegrast may be considered as an option for patients who have an inadequate response to artificial tears.
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Affiliation(s)
- Stacy L Haber
- College of Pharmacy-Glendale, Midwestern University, Glendale, AZ, USA
| | - Vera Benson
- College of Pharmacy-Glendale, Midwestern University, Glendale, AZ, USA
| | - Casey J Buckway
- College of Pharmacy-Glendale, Midwestern University, Glendale, AZ, USA
| | | | - David Romanet
- College of Pharmacy-Glendale, Midwestern University, Glendale, AZ, USA
| | - Brittany Scholes
- College of Pharmacy-Glendale, Midwestern University, Glendale, AZ, USA
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Dumouchel JL, Chemuturi N, Milton MN, Camenisch G, Chastain J, Walles M, Sasseville V, Gunduz M, Iyer GR, Argikar UA. Models and Approaches Describing the Metabolism, Transport, and Toxicity of Drugs Administered by the Ocular Route. Drug Metab Dispos 2018; 46:1670-1683. [DOI: 10.1124/dmd.118.082974] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/10/2018] [Indexed: 11/22/2022] Open
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