Dry eye disease severity does not affect efficacy of varenicline nasal spray
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Varenicline solution nasal spray improved tear production and decreased patient-reported symptoms of dry eye disease, regardless of the severity, according to a study published in Optometry and Vision Science.
“Patients with dry eye disease present in ‘real-world’ clinical settings with a broad range of severities, and notably, 92% of participants in a survey self-reported their symptoms as mild or moderate,” John D. Sheppard, MD, MMSc, of Virginia Eye Consultants and Eyecare Partners in Norfolk, and colleagues wrote. “Given this heterogeneity of the disease, it is important to consider a treatment approach that could benefit patients across a range of disease severities at clinical presentation.”
In an integrated analysis of data from two multicenter, randomized clinical trials, ONSET-1 and ONSET-2, researchers evaluated efficacy outcomes for varenicline solution nasal spray (VNS) in adults with mild to moderate and severe dry eye disease. Researchers defined mild to moderate dry eye as a Schirmer test score (STS) of no greater than 5 and an eye dryness score (EDS) of less than 60, with STS of greater than 5 and EDS of at least 60 indicating severe dry eye disease.
According to results, the percentage of patients achieving at least a 10 mm improvement in STS was higher in the VNS group (48.1%) compared with the control group (25.9%; P < .001). Further, the odds of achieving at least a 10 mm improvement in STS for VNS compared with control was 3.4 and 2.3 for severe and mild to moderate subgroups, respectively.
For patients with an EDS of less than 60 and greater than 60, the odds of improvement were 3.4 in the VNS group and 2.5 in the control group, respectively.
Researchers concluded that VNS improved STS and EDS consistently, regardless of disease severity.
“Our data may further inform clinicians’ decision-making regarding initiating pharmacologic neuro-activation of natural tear production improvements earlier in the treatment course and in managing the complexity of treatment approach considerations for this challenging disorder,” Sheppard and colleagues wrote.
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