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Dry eye specialists share pearls for introducing new treatment
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ANAHEIM, Calif. – Shire has filed for Xiidra approval in Canada and has strong aspirations to bring the product to Europe as well as Asia Pacific, Robert Dempsey, Shire vice president of ophthalmics, said at a company-sponsored event here at the American Academy of Optometry annual meeting.
A panel of dry eye specialists from around the country who were some of the first to begin prescribing Xiidra (lifitegrast ophthalmic solution) shared their experiences.
“You have this catch-all product that has the ability to treat either the signs or symptoms of dry eye; it is really an exciting thing,” Mile Brujic, OD, FAAO, Premier Vision Group, said.
Agustin Gonzalez, OD, spoke about the plethora of knowledge on how to manage dry eye but lack of recently approved treatments.
“Think about all the information we have about dry eye that has appeared in the last 5, 10 years,” Gonzalez, clinical director, Eye & Vision, said. “We haven’t had a new product for the signs and symptoms for some time. The amount of knowledge has grown exponentially but the amount of [treatment] options has not.”
Having an indication for signs and symptoms has given Gonzalez flexibility in managing the disease, he said.
Pictured L to R: Ben Gaddie, Whitney Hauser, Agustin Gonzalez and Mile Brujic
At first, Whitney Hauser, OD, Southern College of Optometry, began prescribing the drops conservatively, in only moderate dry eye patients. After some time, she built on that success and had the confidence to take on more severe cases at the TearWell Advanced Dry Eye Treatment Center.
Brujic added: “Normally we see patients 6 to 8 weeks after a change in treatment regimen. What we found is that some patients saw individual results in 2 weeks, and some took a little longer, which was very consistent with the package insert. It really is about educating the patient on what we are treating, a chronic condition that requires a prescription medication, and setting the expectations, so to speak.”
In the clinical trial, one in five patients experienced altered taste and slight eye irritation, he said. He tells his patients who experience side effects to keep using the product and “stay the course,” if possible, to prevent drop-out.
During an appointment, Ben Gaddie, OD, Gaddie Eye Centers, will explain to a patient what side effects occurred during clinical trials.
He then puts the drop in each eye for the patient, and after 5 minutes he or his team asks what they experienced. Certain patients will experience a side effect and some will not, he said.
“This way they know what to expect, and it’s really been effective to diffuse unexpected results from patients,” Gaddie added.
Gonzalez uses the trial data to find his first patient population for a new treatment.
“I look at the clinical trial and see what the patient profile was for those who have benefited from the therapy and replicate that population within my own patients,” he said.
He added that being able to script his message, with the benefits and risks of a medication, has been helpful to his busy practice. – by Abigail Sutton
Disclosures: Brujic, Gaddie, Gonzalez and Hauser are consultants for Shire. Dempsey is vice president of ophthalmics for Shire.