Real-world insights and outcomes related to ciclosporin A 0.1% cationic emulsion for the long-term treatment of dry eye disease in Germany: Country-level sub-analysis of the PERSPECTIVE study

Ines Lanzl; Christoph M E Deuter; Katrin Lorenz; Gerd Geerling; PERSPECTIVE German study group

doi:10.1007/s00417-024-06414-z

Real-world insights and outcomes related to ciclosporin A 0.1% cationic emulsion for the long-term treatment of dry eye disease in Germany: Country-level sub-analysis of the PERSPECTIVE study

Graefes Arch Clin Exp Ophthalmol. 2024 May 9. doi: 10.1007/s00417-024-06414-z. Online ahead of print.

Authors

Ines Lanzl^{1

2}, Christoph M E Deuter³, Katrin Lorenz⁴, Gerd Geerling⁵; PERSPECTIVE German study group

Affiliations

¹ Chiemsee Augen Tagesklinik, Geigelsteinstrasse 26, 83209, Prien, Germany. info@auge.bayern.
² Department of Ophthalmology, Technical University of Munich, Munich, Germany. info@auge.bayern.
³ Centre for Ophthalmology, Eberhard-Karls-University, Tübingen, Germany.
⁴ Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.
⁵ Department of Ophthalmology, University Hospital Düsseldorf, Düsseldorf, Germany.

PMID: 38722320
DOI: 10.1007/s00417-024-06414-z

Abstract

Purpose: The PERSPECTIVE study was a real-world European, non-interventional, multicenter, observational study that evaluated the effectiveness, tolerability, and safety of ciclosporin A (CsA) 0.1% cationic emulsion (CE) in routine clinical practice as a treatment for adults with severe keratitis and dry eye disease (DED) that remained insufficiently controlled with artificial tears. This sub-analysis examined data from ophthalmology clinics in Germany to provide more precise insights into treatment patterns, outcomes, and clinical decision-making related to CsA 0.1% CE.

Methods: Study data were collected from adults starting CsA 0.1% CE (one drop in both eyes at bedtime) and followed up at Week 4, 12, and 24, and Month 12. The primary endpoint was mean change from baseline in corneal fluorescein staining (CFS) score (Oxford Grade Scale) at Month 12. Secondary endpoints examined the severity of ocular signs and symptoms, and adverse events (AEs).

Results: A total of 236 patients from 20 ophthalmology clinics in Germany participated in the PERSPECTIVE study (69.9% female; mean age 60.8 years). Following treatment with CsA 0.1% CE, patients experienced significant reductions in CFS score from Week 4, which were maintained through to Month 12 (P < 0.0001). From baseline, 81.6% of patients experienced an improvement in CFS score at Month 12. CsA 0.1% CE provided significant reductions in the severity of eyelid and conjunctival erythema at Month 12 compared with baseline (P < 0.001), as well as significant reductions in the severity of subjective ocular symptoms (all P ≤ 0.015). Safety data were consistent with the known safety profile of CsA 0.1% CE. Tolerability was rated as "satisfactory," "good," or "very good" by 97.2% of physicians and 95.7% of patients.

Conclusion: Outcomes in Germany were similar to those reported for the overall European study population and are indicative of the treatment results that ophthalmologists may expect to see with CsA 0.1% CE treatment in real-life clinical practice. Treatment with CsA 0.1% CE provided long-term improvements over 12 months and was generally well tolerated.

Keywords: Ciclosporin A 0.1% cationic emulsion; Dry eye disease; Germany; PERSPECTIVE study; Real-world evidence; Severe keratitis.