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

Jing-Xing Li; Yi-Yu Tsai; Chun-Ting Lai; You-Ling Li; Ying-Hsuen Wu; Chun-Chi Chiang

doi:10.3390/jcm11175014

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

J Clin Med. 2022 Aug 26;11(17):5014. doi: 10.3390/jcm11175014.

Authors

Jing-Xing Li^{1

2

3}, Yi-Yu Tsai^{2

4

5}, Chun-Ting Lai^{4

6}, You-Ling Li^{2

4}, Ying-Hsuen Wu⁴, Chun-Chi Chiang^{2

4

5}

Affiliations

¹ Department of General Medicine, China Medical University Hospital, Taichung 404327, Taiwan.
² School of Medicine, China Medical University, Taichung 406040, Taiwan.
³ Institute of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University, Taipei 100233, Taiwan.
⁴ Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan.
⁵ Department of Optometry, Asia University, Taichung 413305, Taiwan.
⁶ School of Medicine, National Taiwan University, Taipei 100233, Taiwan.

Abstract

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.

Keywords: DED; LFA-1; Xiidra; dry eye disease; lifitegrast; lymphocyte function-associated antigen 1.

Publication types

Review

Grants and funding

The authors received no financial support for the research, authorship, and/or publication of this article.