Lifitegrast: a novel drug for patients with dry eye disease

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.

Ocular manifestations of rosacea: A clinical review

“…Lifitegrast 5% ophthalmic solution (Xiidra, Shire, Lexington, Massachusetts) is a first in class, selective antagonist to lymphocyte function‐associated antigen‐1 (LFA‐1) and reduces T cell‐mediated inflammation. Lifitegrast inhibits the interactions between LFA‐1 and its ligand ICAM‐1, which is expressed in vascular endothelial cells in the presence of infection or inflammation, and is overexpressed in corneal and conjunctival tissues in dry eyes 89 . While the original phase 3 studies were performed for dry eye disease, a recent prospective, randomized, single‐masked study enrolled patients with inflammatory MGD.…”

“…Lifitegrast inhibits the interactions between LFA-1 and its ligand ICAM-1, which is expressed in vascular endothelial cells in the presence of infection or inflammation, and is overexpressed in corneal and conjunctival tissues in dry eyes. 89 While the original phase 3 studies were performed for dry eye disease, a recent prospective, randomized, single-masked study enrolled patients with inflammatory MGD. In this study, lifitegrast twice daily for 42 days was compared to a single treatment with thermal pulsation.…”

Cataract surgery and dry eye disease: A review

“… 127 It has a rapid onset of action, possibly as a result of multi-target action on the inflammatory cycle, and it has ability to modulate already active T-cells. 128 – 130 It has been shown in multiple clinical trials to be effective for the treatment of DED 128 – 130 including severe cases such as those with graft versus host disease. 131 In such studies it has been shown to significantly improve inferior corneal fluorescein staining scores and eye dryness scores, with limited adverse effects such as ocular irritation and dysgeusia.…”

Impact of Attrition, Intercellular Shear in Dry Eye Disease: When Cells are Challenged and Neurons are Triggered

“…Its presence in human corneal epithelium is very important, as TSG-6, a multifunctional protein [ 91 ], has anti-inflammatory effects and appears to be capable of downregulating inflammatory response [ 92 ]. The external application of TSG-6 in the treatment of dry eye has shown promising effects [ 13 ], as well as the application of immunomodulators such as ICAM-1 inhibitors [ 93 , 94 , 95 , 96 , 97 ] and Cyclosporin-A [ 98 , 99 , 100 , 101 , 102 ].…”