A twice-daily cyclosporine drop administered in a chondroitin sulfate emulsion is safe and effective for reducing signs and symptoms of dry eye disease (DED), according to the results of a retrospective multicenter published in Clinical Ophthalmology. The research was conducted by Cynthia Matossian, MD, of Matossian Eye in Hopewell, New Jersey, and William Trattler, MD, of Center for Excellence in Eye Care and Jennifer Loh, MD of Loh Ophthalmology Associates, both in Miami.

The investigation included 100 eyes of 50 patients with DED and ocular surface disease index (OSDI) scores of at least 12, or corneal staining grades greater than 1 in either eye. All patients were older than 18 years of age when they initiated treatment with topical cyclosporine 0.1% in chondroitin sulfate emulsion. They were treated for 3 months and then evaluated for changes in OSDI score and corneal staining grade. 

Overall, patients who reported DED symptoms dropped to 20% from 62%, and 34% of patients were in the normal OSDI range after using the cyclosporine 0.1% in chondroitin sulfate emulsion for 3 months. The study shows a statistically significant improvement in mean OSDI score from baseline to 3 months (38.19 vs 24.18, P <.001) and a reduction in mean corneal staining grade (3.62 vs 2.20, P <.001). 


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Prior research shows a lubricating effect is associated with chondroitin sulfate. This chemical can also act as a cell membrane stabilizer that enhances healing and reduces cell death and apoptosis, according to the investigators. Combined with cyclosporine A, it may have a synergistic anti-inflammatory effect that hastens symptomatic DED improvement. 

Dry eye disease treatments are plagued by poor drug tolerability, which the research team says “remains a major reason for noncompliance or treatment discontinuation.” Chondroitin sulfate’s additional lubrication and mild anti-inflammatory effects may improve comfort and, ultimately, compliance for this patient class, the investigators speculate.

“Twice-daily dosing of the study drug led to a statistically significant reduction in the mean OSDI score and corneal staining grade score from baseline to 3 months,” the researchers report.

The study’s limitations include its relatively small sample size, its retrospective nature, and the absence of a control arm. The tolerability of the drug was not evaluated.

Disclosure: This research was supported by ImprimisRx®. Please see the original reference for a full list of authors’ disclosures. 

Reference

Matossian C, Trattler W, Loh J. Dry eye treatment with topical cyclosporine 0.1% in chondroitin sulfate ophthalmic emulsion. Clin Ophthalmol. 2021;15(5):1979-1984. doi:10.2147/OPTH.S308088