Lifitegrast Ophthalmic Solution 5% Is a Safe and Efficient Eyedrop for Dry Eye Disease: A Systematic Review and Meta-Analysis

Dry eye disease (DED) is a multifactorial disease that causes ocular discomfort and visual impairment on a damaged ocular surface. Lifitegrast, a novel T-cell integrin antagonist, was approved in the United States in July 2016 as a 5% (50 mg/mL) ophthalmic solution for DED management. Currently, no...

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Main Authors: Jing-Xing Li, Yi-Yu Tsai, Chun-Ting Lai, You-Ling Li, Ying-Hsuen Wu, Chun-Chi Chiang
Format: Article
Language:English
Published: MDPI AG 2022-08-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/11/17/5014
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author Jing-Xing Li
Yi-Yu Tsai
Chun-Ting Lai
You-Ling Li
Ying-Hsuen Wu
Chun-Chi Chiang
author_facet Jing-Xing Li
Yi-Yu Tsai
Chun-Ting Lai
You-Ling Li
Ying-Hsuen Wu
Chun-Chi Chiang
author_sort Jing-Xing Li
collection DOAJ
description Dry eye disease (DED) is a multifactorial disease that causes ocular discomfort and visual impairment on a damaged ocular surface. Lifitegrast, a novel T-cell integrin antagonist, was approved in the United States in July 2016 as a 5% (50 mg/mL) ophthalmic solution for DED management. Currently, no meta-analysis and systemic review based on relevant studies have been conducted. This study aimed to evaluate the efficacy and safety of lifitegrast in patients with DED. We systematically searched Embase, Medline, PubMed, and Web of Science for randomized controlled trials (RCTs) and nonrandomized studies evaluating lifitegrast effects on symptomatic DED. Then, inferior corneal staining score, total corneal staining score (TCSS), nasal lissamine staining score (NLSS), total lissamine staining score, ocular discomfort score (ODS), eye discomfort score (visual analog scale (VAS) score), eye dryness score (EDS), ocular surface disease index score (OSDI-S), and tear break-up time (TBUT) were assessed. Clinical global impression and safety profiles were also evaluated. The studies were pooled in a random-effects model. We included five RCTs, one case–control study, and four longitudinal or retrospective studies, comprising 3197 participants. In the meta-analysis, lifitegrast was superior to the placebo because it improved TCSS, NLSS, TBUT, ODS, eye discomfort score, EDS, and OSDI-Sin DED. However, lifitegrast showed higher risks for ocular and non-ocular treatment-emergent adverse events (TEAEs) overall or at a mild or moderate level. Nonetheless, its incidence of adverse events slightly differed from that in the placebo, especially instillation site discomforts and dysgeusia, thereby considered safe and tolerable. Claims of withdrawal during follow-up caused by TEAEs were extremely rare. Lifitegrast improves DED, although dysgeusia, installation site pain, and irritation may be a concern for some. Overall, most of the adverse events are tolerable. Lifitegrast can alleviate refractory DED and improves patients’ quality of life.
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spelling doaj.art-7a189301d68e4a55a011bc988c5b0bfb2023-11-23T13:26:15ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011117501410.3390/jcm11175014Lifitegrast Ophthalmic Solution 5% Is a Safe and Efficient Eyedrop for Dry Eye Disease: A Systematic Review and Meta-AnalysisJing-Xing Li0Yi-Yu Tsai1Chun-Ting Lai2You-Ling Li3Ying-Hsuen Wu4Chun-Chi Chiang5Department of General Medicine, China Medical University Hospital, Taichung 404327, TaiwanSchool of Medicine, China Medical University, Taichung 406040, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, TaiwanSchool of Medicine, China Medical University, Taichung 406040, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, TaiwanSchool of Medicine, China Medical University, Taichung 406040, TaiwanDry eye disease (DED) is a multifactorial disease that causes ocular discomfort and visual impairment on a damaged ocular surface. Lifitegrast, a novel T-cell integrin antagonist, was approved in the United States in July 2016 as a 5% (50 mg/mL) ophthalmic solution for DED management. Currently, no meta-analysis and systemic review based on relevant studies have been conducted. This study aimed to evaluate the efficacy and safety of lifitegrast in patients with DED. We systematically searched Embase, Medline, PubMed, and Web of Science for randomized controlled trials (RCTs) and nonrandomized studies evaluating lifitegrast effects on symptomatic DED. Then, inferior corneal staining score, total corneal staining score (TCSS), nasal lissamine staining score (NLSS), total lissamine staining score, ocular discomfort score (ODS), eye discomfort score (visual analog scale (VAS) score), eye dryness score (EDS), ocular surface disease index score (OSDI-S), and tear break-up time (TBUT) were assessed. Clinical global impression and safety profiles were also evaluated. The studies were pooled in a random-effects model. We included five RCTs, one case–control study, and four longitudinal or retrospective studies, comprising 3197 participants. In the meta-analysis, lifitegrast was superior to the placebo because it improved TCSS, NLSS, TBUT, ODS, eye discomfort score, EDS, and OSDI-Sin DED. However, lifitegrast showed higher risks for ocular and non-ocular treatment-emergent adverse events (TEAEs) overall or at a mild or moderate level. Nonetheless, its incidence of adverse events slightly differed from that in the placebo, especially instillation site discomforts and dysgeusia, thereby considered safe and tolerable. Claims of withdrawal during follow-up caused by TEAEs were extremely rare. Lifitegrast improves DED, although dysgeusia, installation site pain, and irritation may be a concern for some. Overall, most of the adverse events are tolerable. Lifitegrast can alleviate refractory DED and improves patients’ quality of life.https://www.mdpi.com/2077-0383/11/17/5014dry eye diseaseDEDlifitegrastlymphocyte function-associated antigen 1LFA-1Xiidra
spellingShingle Jing-Xing Li
Yi-Yu Tsai
Chun-Ting Lai
You-Ling Li
Ying-Hsuen Wu
Chun-Chi Chiang
Lifitegrast Ophthalmic Solution 5% Is a Safe and Efficient Eyedrop for Dry Eye Disease: A Systematic Review and Meta-Analysis
Journal of Clinical Medicine
dry eye disease
DED
lifitegrast
lymphocyte function-associated antigen 1
LFA-1
Xiidra
title Lifitegrast Ophthalmic Solution 5% Is a Safe and Efficient Eyedrop for Dry Eye Disease: A Systematic Review and Meta-Analysis
title_full Lifitegrast Ophthalmic Solution 5% Is a Safe and Efficient Eyedrop for Dry Eye Disease: A Systematic Review and Meta-Analysis
title_fullStr Lifitegrast Ophthalmic Solution 5% Is a Safe and Efficient Eyedrop for Dry Eye Disease: A Systematic Review and Meta-Analysis
title_full_unstemmed Lifitegrast Ophthalmic Solution 5% Is a Safe and Efficient Eyedrop for Dry Eye Disease: A Systematic Review and Meta-Analysis
title_short Lifitegrast Ophthalmic Solution 5% Is a Safe and Efficient Eyedrop for Dry Eye Disease: A Systematic Review and Meta-Analysis
title_sort lifitegrast ophthalmic solution 5 is a safe and efficient eyedrop for dry eye disease a systematic review and meta analysis
topic dry eye disease
DED
lifitegrast
lymphocyte function-associated antigen 1
LFA-1
Xiidra
url https://www.mdpi.com/2077-0383/11/17/5014
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