An update on dry eye disease molecular treatment: advances in drug pipelines

Expert Opin Pharmacother. 2014 Jul;15(10):1371-90. doi: 10.1517/14656566.2014.914492. Epub 2014 Apr 29.

Abstract

Introduction: Dry eye disease is a common disorder provoking changes in tear film and ocular surface. Untreated dry eye could cause ocular infections, corneal ulcer and blindness. Only a few drugs are authorized so far for the treatment of dry eye disease and the possibilities of evolution in this sector are immense. Consequently, a significant number of new potential solutions are under development or placed in the pharmaceutical pipeline, promising better results and lesser side effects.

Areas covered: In this article, the corresponding literature and recent Phase III clinical trial data and the corresponding literature, for dry eye disease treatment are reviewed, revealing the new strategic movements in drug pipelines.

Expert opinion: From the clinical trial results, the advancement in tear substitutes and secretagogues in addressing specific deficiencies of tear components even though not resolving the underlying conditions of the disease is evident. The vast majority of new compounds under development are anti-inflammatories, steroids, non-steroids and antibiotics; however, there are also some novel lubricating drops and mucin-tear secretagogues. A future aggressive therapy for dry eye, depending on the severity of the symptoms, would include combinations of soft steroids, anti-inflammatories, such as cyclosporine A, with the addition of the new polyvalent mucin and tear secretagogues.

Keywords: NSAID; anti-inflammatory; corticosteroids; dry eye; keratitis sicca; keratoconjunctivitis sicca; mucin secretion; tear secretion; xerophthalmia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Clinical Trials, Phase III as Topic
  • Dry Eye Syndromes / diagnosis
  • Dry Eye Syndromes / drug therapy*
  • Dry Eye Syndromes / metabolism
  • Humans
  • Molecular Targeted Therapy
  • Tears / chemistry
  • Tears / physiology

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal