STEPS

New Drug Reviews

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

 

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

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DrugDosageDose formCost*

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).

DrugDosageDose formCost*

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.

 

 

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