Lifitegrast Ophthalmic Solution 5% (Xiidra) for Dry Eye Disease

Jay Patel; John Franko

<< Previous article

Next article >>

Jul 15, 2018 Issue

STEPS

New Drug Reviews

Lifitegrast Ophthalmic Solution 5% (Xiidra) for Dry Eye Disease

JAY PATEL, MD, MPH, and JOHN FRANKO, MD, Atrium Health Department of Family Medicine, Charlotte, North Carolina

Am Fam Physician. 2018 Jul 15;98(2):119-120.

Lifitegrast ophthalmic solution 5% (Xiidra) is labeled for the treatment of dry eye disease, also known as keratoconjunctivitis sicca.1 It is an inhibitor of the lymphocyte function–associated antigen 1 (LFA-1) and has been shown to reduce immune-mediated inflammation.1

Enlarge Print

Drug	Dosage	Dose form	Cost*
Lifitegrast ophthalmic solution 5% (Xiidra)	One drop in each eye every 12 hours	Single-use ampule of 5% solution	$527

*—Estimated retail price of one month's treatment based on information obtained at http://www.goodrx.com (accessed June 4, 2018).

Drug	Dosage	Dose form	Cost*
Lifitegrast ophthalmic solution 5% (Xiidra)	One drop in each eye every 12 hours	Single-use ampule of 5% solution	$527

*—Estimated retail price of one month's treatment based on information obtained at http://www.goodrx.com (accessed June 4, 2018).

Safety

No serious adverse effects have been reported with the use of lifitegrast in clinical trials of up to one year in duration.2 Lifitegrast is not systemically detectable despite long-term administration, making systemic effects unlikely.1,2 The medication has not been studied in women who are pregnant or breastfeeding, children, or adolescents.1

Tolerability

Approximately one in eight patients will discontinue lifitegrast therapy because of adverse effects.2 The most common adverse effects are altered taste (16.2%), eye irritation or burning (15%), and visual acuity reduction (11.4%).2

Effectiveness

Lifitegrast has been evaluated in four 12-week randomized controlled trials involving a total of 2,132 patients.3 Patients receiving lifitegrast initially had moderate symptoms, an average score of 40 to 70 on a scale of 0 to 100, and some corneal lesions on fluorescein stain.3 Patients who received lifitegrast experienced a small reduction in symptoms (an average of 14 to 38 points), although these scores were only five to 12 points better than with placebo.3 Corneal lesions improved at a rate similar to that of placebo. Lifitegrast has not

Address correspondence to Jay Patel, MD, MPH, at jay.i.patel@carolinashealthcare.org. Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.

References

1. Daily Med. Drug label information: Xiidra—lifitegrast solution/drops. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ac09d19a-e321-4556-8a5c-66bd27cb6533. Accessed September 10, 2017.

2. Donnenfeld ED, Karpecki PM, Majmudar PA, et al. Safety of lifitegrast ophthalmic solution 5.0% in patients with dry eye disease: a 1-year, multicenter, randomized, placebo-controlled study. Cornea. 2016;35(6):741–748.

3. Xiidra FDA Summary Review. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208073Orig1s000SumR.pdf. Accessed November 11, 2017.

STEPS new drug reviews cover Safety, Tolerability, Effectiveness, Price, and Simplicity. Each independent review is provided by authors who have no financial association with the drug manufacturer.

This series is coordinated by Allen F. Shaughnessy, PharmD, Tufts University Family Medicine Residency Program at Cambridge Health Alliance, Malden, Mass.

A collection of STEPS published in AFP is available at https://www.aafp.org/afp/steps.

Copyright © 2018 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.