Improving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears

Alice T Epitropoulos,1 Anthony Therattil,2 Laura M Periman,3 Eric D Rosenberg4 1Ophthalmic Surgeons & Consultants of Ohio, The Eye Center of Columbus, Department of Ophthalmology, The Ohio State University Wexner Medical Center, Columbus, OH, USA; 2New York Medical College, School of Medicin...

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Autores principales: Epitropoulos AT, Therattil A, Periman LM, Rosenberg ED
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Publicado: Dove Medical Press 2020
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spelling oai:doaj.org-article:9a1e72658e7c4eaeaee825f023b74bf62021-12-02T12:55:13ZImproving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears1177-5483https://doaj.org/article/9a1e72658e7c4eaeaee825f023b74bf62020-07-01T00:00:00Zhttps://www.dovepress.com/improving-tolerance-and-compliance-with-topical-immunomodulators-using-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Alice T Epitropoulos,1 Anthony Therattil,2 Laura M Periman,3 Eric D Rosenberg4 1Ophthalmic Surgeons & Consultants of Ohio, The Eye Center of Columbus, Department of Ophthalmology, The Ohio State University Wexner Medical Center, Columbus, OH, USA; 2New York Medical College, School of Medicine, Valhalla, NY, USA; 3Periman Eye Institute, Seattle, WA, USA; 4Weill-Cornell Medical College, Department of Ophthalmology, New York, NY, USACorrespondence: Alice T EpitropoulosOphthalmic Surgeons & Consultants of Ohio at the Eye Center of Columbus, 262 Neil Ave #430, Columbus, Ohio 43215 Tel +1 614-221-7464Email EyesMD33@gmail.comPurpose: To investigate the efficacy of a micro-emulsion (ME) lipid layer artificial tear in improving tolerance of immunomodulator eye drops for the treatment of dry eye disease.Patients and Methods: A total of 33 patients with previously diagnosed dry eye disease were given the micro-emulsion lipid layer artificial tear in conjunction with either lifitegrast or cyclosporine. Patients were queried on their tolerance of the regimen by reporting VAS scores before starting the adjunctive eye drop, immediately after starting, and 2– 3 weeks later. Tolerance was statistically compared over time and with respect to previous medication compliance, timing of the adjunctive eye drop, age, gender, and ethnicity.Results: Across all patients, the VAS pre-treatment score (6.8 ± 0.6) was significantly higher than both the VAS 1-day post ME lipid tear instillation time point (3.0 ± 0.7) (post hoc Bonferroni, p < 0.001) and the VAS 2– 3-week post instillation time point (1.7 ± 0.7) (post hoc Bonferroni, p < 0.001), with the mean VAS score improving over time (post hoc Bonferroni, p < 0.028). Average VAS scores did not vary with respect to specific medical therapy or the timing of instillation of this artificial tear. Both the “at-risk” and “conversion” groups independently had significant improvements at both 1-day and 2– 3-week time points compared to baseline.Conclusion: The micro-emulsion lipid layer artificial tear was effective as an adjunctive eye drop to improve tolerance of lifitegrast and cyclosporine for patients with dry eye disease who were at risk of failing or had previously failed immunomodulatory therapy.Keywords: dry eye disease, cyclosporine, lifitegrast, artificial tearsEpitropoulos ATTherattil APeriman LMRosenberg EDDove Medical Pressarticledry eye diseasecyclosporinelifitegrastartificial tearsOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 1921-1929 (2020)
institution DOAJ
collection DOAJ
language EN
topic dry eye disease
cyclosporine
lifitegrast
artificial tears
Ophthalmology
RE1-994
spellingShingle dry eye disease
cyclosporine
lifitegrast
artificial tears
Ophthalmology
RE1-994
Epitropoulos AT
Therattil A
Periman LM
Rosenberg ED
Improving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears
description Alice T Epitropoulos,1 Anthony Therattil,2 Laura M Periman,3 Eric D Rosenberg4 1Ophthalmic Surgeons & Consultants of Ohio, The Eye Center of Columbus, Department of Ophthalmology, The Ohio State University Wexner Medical Center, Columbus, OH, USA; 2New York Medical College, School of Medicine, Valhalla, NY, USA; 3Periman Eye Institute, Seattle, WA, USA; 4Weill-Cornell Medical College, Department of Ophthalmology, New York, NY, USACorrespondence: Alice T EpitropoulosOphthalmic Surgeons & Consultants of Ohio at the Eye Center of Columbus, 262 Neil Ave #430, Columbus, Ohio 43215 Tel +1 614-221-7464Email EyesMD33@gmail.comPurpose: To investigate the efficacy of a micro-emulsion (ME) lipid layer artificial tear in improving tolerance of immunomodulator eye drops for the treatment of dry eye disease.Patients and Methods: A total of 33 patients with previously diagnosed dry eye disease were given the micro-emulsion lipid layer artificial tear in conjunction with either lifitegrast or cyclosporine. Patients were queried on their tolerance of the regimen by reporting VAS scores before starting the adjunctive eye drop, immediately after starting, and 2– 3 weeks later. Tolerance was statistically compared over time and with respect to previous medication compliance, timing of the adjunctive eye drop, age, gender, and ethnicity.Results: Across all patients, the VAS pre-treatment score (6.8 ± 0.6) was significantly higher than both the VAS 1-day post ME lipid tear instillation time point (3.0 ± 0.7) (post hoc Bonferroni, p < 0.001) and the VAS 2– 3-week post instillation time point (1.7 ± 0.7) (post hoc Bonferroni, p < 0.001), with the mean VAS score improving over time (post hoc Bonferroni, p < 0.028). Average VAS scores did not vary with respect to specific medical therapy or the timing of instillation of this artificial tear. Both the “at-risk” and “conversion” groups independently had significant improvements at both 1-day and 2– 3-week time points compared to baseline.Conclusion: The micro-emulsion lipid layer artificial tear was effective as an adjunctive eye drop to improve tolerance of lifitegrast and cyclosporine for patients with dry eye disease who were at risk of failing or had previously failed immunomodulatory therapy.Keywords: dry eye disease, cyclosporine, lifitegrast, artificial tears
format article
author Epitropoulos AT
Therattil A
Periman LM
Rosenberg ED
author_facet Epitropoulos AT
Therattil A
Periman LM
Rosenberg ED
author_sort Epitropoulos AT
title Improving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears
title_short Improving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears
title_full Improving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears
title_fullStr Improving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears
title_full_unstemmed Improving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears
title_sort improving tolerance and compliance with topical immunomodulators using micro-emulsion lipid layer artificial tears
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/9a1e72658e7c4eaeaee825f023b74bf6
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AT rosenberged improvingtoleranceandcompliancewithtopicalimmunomodulatorsusingmicroemulsionlipidlayerartificialtears
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