Dry eye disease (DED) is a common medical condition, and according to the National Eye Institute, it affects about 16 million Americans, including women, people over 50, and contact lens wearers. The rising number of DED diagnoses is related to the increase in usage of smartphones, tablets, computers, and other electronic devices.
Available Medications
Let’s take a look at some of the available DED drugs on the market. Jacee Billings, Pharm.D, the 2024-2025 Maxor PGY2 Specialty Pharmacy Administration and Leadership Resident, provides input on several of these medicines.
Restasis® received Food and Drug Administration (FDA) approval in 2003 and is composed of 0.05% cyclosporine, which is used to decrease inflammation. Billings explains how the drug works: “Simply put, Restasis calms down the immune system’s overactive response that leads to dryness and irritation in the eyes.”
Xiidra® received FDA approval in 2016. It is composed of 6% liftegrast, which is also used to treat inflammation. Liftegrast acts differently from cyclosporine and is part of a new class of drugs called lymphocyte function-associated antigen 1 (LFA-1) antagonists. “LFA-1 antagonists work by blocking a protein involved in inflammation and immune response. When looking at dry eye disease, these antagonists help to reduce inflammation on the surface of the eye,” says Billings. She explains the difference between Restasis and Xiidra: “Xiidra directly stops inflammation where Restasis adjusts the immune system’s response to reduce dryness.”
Cequa® received FDA approval in 2018. The amount of cyclosporine- at 0.09%- is slightly higher than in Restasis. Cequa also penetrates deeper into the eye than Restasis.
Tyrvaya® received FDA approval in 2021 and is a nasal spray. “The nasal spray is an interesting alternative [to eye drops],” says Billings. She says the spray might be a good option for patients with dexterity issues, like arthritis. “The nasal spray also offers the benefit of creating tears versus utilizing artificial tears, sometimes containing preservatives,” says Billings.
Miebo® was approved by the FDA in 2023. It is distinct from other eye drops because it focuses on tear evaporation.
What’s happening in 2024?
Reproxalap is a first-in-class small-molecule modulator of reactive aldehyde species. In 2023, the FDA rejected the drug due to lack of clinical evidence, among other issues. It may be resubmitted this year.
AR-15512, a topical drug candidate, may also be submitted to the FDA this year.
“Given the safety data of both drugs, sufficient resources to conduct further trials, and interest in further development of DED treatments, there is a high likelihood of them reaching FDA approval,” says Billings.
Disclaimer: The foregoing does not constitute medical advice. Always consult with a qualified and licensed physician or other medical professional.
Related Links
- 340B Report Sponsored Article: PBM is not a 4-letter word
- Realizing the value of pharmacy with an integrated pharmacy strategy
- Digital Programs to Enhance Patient Care
Learn more about Maxor today!
Fill out the form below to learn more about how Maxor helps optimize the pharmacy experience for your patients and your employees through customized pharmacy benefit offerings, providing access to prescription medications and home therapies through home delivery and specialty pharmacies, and delivering clinical and financial value with our end-to-end pharmacy management, 340B optimization, and specialty pharmacy solutions.
