Doxycycline promising adjunctive therapy for lowering IOP
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SAN DIEGO — Results from a pilot study showed that low-dose doxycycline may hold promise as an adjunct treatment for IOP reduction, according to a poster presented at Academy 2022.
Study co-author Dominick L. Opitz, OD, FAAO, of the Illinois College of Optometry, told Healio that a patient with glaucoma whom he treated with doxycycline for concomitant ocular surface disease experienced an IOP reduction of 26% to 35%.
“Because this patient had a significant IOP reduction, I developed a prospective study to further evaluate the effect of low-dose doxycycline on IOP,” he said. “I did not know if the single patient was by chance or if the doxycycline actually had a direct effect on lower the IOP.”
In this prospective study, patients treated with topical IOP-lowering medications for mild or moderate but stable open-angle glaucoma who also had ocular surface disease were treated with 50 mg doxycycline hyclate per day for 90 days while keeping the IOP-lowering drops the same, Opitz said. IOP was measured at baseline, 30 days, 90 days and 180 days.
“Mean baseline IOP was 16.0 mm Hg ± 3.58. At 1 month there was an 8.31% reduction in IOP (mean 14.67 mm Hg ± 3.33, P = 0.102),” he said. “At 3 months, IOP was significantly reduced by 15.63% from baseline (mean 13.5 mm Hg ± 3.83, P = 0.007). At 6 months, after discontinuing doxycycline, IOP was 4.38% lower than baseline (mean 15.3 mm Hg ± 3.67, P = 0.235) and 11.76% significantly higher when compared to mean IOP at 3 months (P = 0.006).”
Standard Patient Evaluation of Eye Dryness (SPEED) scores were also measured.
“Mean SPEED score at baseline was 10.17 ± 7.55,” Opitz said. “SPEED score decreased significantly at 1-month (mean 2.83 ± 3.37, P = 0.04), 3-month (mean 2.67 ± 2.5, P = 0.024) and 6-month follow-up (mean 4.5 ± 4.37, P = 0.031).”
“We do not understand the mechanism for why low-dose doxycycline lowered IOP,” he said.
However, the researchers hypothesized in the study that the anti-inflammatory effect of doxycycline may also reduce trabecular meshwork inflammation, thereby reducing resistance to outflow.
“Because our initial cohort demonstrated a clinical and statistically significant IOP reduction, we plan to continue the study with the goal of enrolling 30-plus patients,” Opitz said.
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Hohs K, et al. A pilot study of low-dose doxycycline to lower IOP in patients with glaucoma and ocular surface disease. Presented at: Academy; Oct. 26-29, 2022; San Diego.
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