September 15, 2011
Dry eye research: Remedies under development for dry eyes
Potential treatments
The cure for eye strain/ dry eyes (for most cases of dry eye) |
RGN-259
RGN-259 has been shown to reduce ocular surface defects associated with dry eye syndrome in two animal models when compared to both positive and negative controls. In one experiment, RGN-259 performed better than Restasis™ in reducing such damage. [Source]
Unfortunately in phase 2 trial, it has not done well (see this)
MIM-D3
MIM-D3 [also see this] and this.
The trial demonstrated statistically significant improvements in signs and symptoms with its doses of MIM-D3. Mimetogen is in the process of completing its analysis of the data, and intends to present further details at a future medical conference.
The 150-patient phase II study utilized a controlled adverse environment (CAETM) chamber to measure dry eye patients’ ability to withstand a stressful drying environment on the eye, and patient diaries to measure the severity of their dry eye symptoms over the course of the study. Patients were randomized to receive MIM-D3 low dose, MIM-D3 high dose or placebo twice/day over the course of a 28-day study.
List of remedies in the pipeline.
EyeGate, Novagali, Resolvyx and SARcode all have therapies under development and are currently in Phase 3 of FDA approval.
SAR 1118
Lipiflow endorsed by FDA. (also this) [LipiFlow® Thermal Pulsation System for the treatment of meibomian gland dysfunction (MGD). TearScience’s integrated, in-office system addresses a root cause of evaporative dry eye, the obstructed glands. By assessing the tear film and meibomian gland function, physicians can determine whether MGD is the primary cause of a patient’s evaporative dry eye and whether a patient is a good candidate for the LipiFlow® treatment. [Source]
SAR 1118 is a first-in-class molecule that inhibits T-cell inflammation by blocking the binding of two key cellular surface proteins (LFA-1 and ICAM-1) that mediate the chronic inflammatory cascade. SAR 1118 may be able to reduce inflammation associated with dry eye disease. [Source]
RegeneRx dry eye treatment misses primary outcomes in phase 2 trial
BOOK
Research projects in dry eye syndrome volume editor, Horst Brewitt, Published: Basel [Switzerland] ; New York: Karger, c2010. Summary: Offered to Prof. Behrens-Baumann, the director of the U. of Magdeburg Eye Clinic, as a 65th birthday festschrift, this collection of 14 articles presents current research on diagnosis and treatment of dry eye syndrome, by ophthalmologists based mainly in Germany. The chapter topics include possible use of trefoil factor family peptide 3 at the ocular surface, the importance of the lid marigin in ocular surface health, generation of two-and three-dimensional lacrimal gland constructs, and the diagnostic markers of Sjögren's syndrome. The articles are written for other specialists in the field. Each includes an abstract, list of references, and drawings and clinical photos in b&w plates of the best quality. Annotation ©2010 Book News, Inc., Portland, OR (booknews.com)
Contents: Trefoil factor family peptide 3 at the ocular surface / Schulze, U.; Sel, S.; Paulsen, F.P. — Cationic amino acid transporters and [beta]-defensins in dry eye syndrome / Jäger, K. … [et al.] — Antimicrobial peptides as a major part of the innate immune defense at the ocular surface / Garreis, F.; Gottschalt, M.; Paulsen, F.P. — Regulation of the inflammatory component in chronic dry eye disease by the eye-associated lymphoid tissue (EALT) / Knop, N.; Knop, E. — Intravital multidimensional real-time imaging of the conjunctival immune system / Gehlsen, U.; Hüttmann, G.; Steven, P. — Generation of two- and three-dimensional lacrimal gland constructs / Schrader, S. … [et al.] — Midterm results of cultivated autologous and allogeneic limbal epithelial transplantation in limbal stem cell deficiency / Pauklin, M. … [et al.] — Laser scanning confocal microscopy for conjunctival epithelium imaging / Jürgens, C. … [et al.] — Pollen enzymes degrade human tear fluid and conjunctival cells : an approach to understanding seasonal non-allergic conjunctivitis / Rabensteiner, D.F. … [et al.] — Towards a new in vitro model of dry eye : the ex vivo eye irritation test / Spöler, F.; Frentz, M.; Schrage, N.F. — The lid margin is an underestimated structure for preservation of ocular surface health and development of dry eye disease / Knop, E. … [et al.] — Diagnostic markers of sjögren?s syndrome / Witte, T. — Hyperosmolarity of the tear film in dry eye syndrome / Messmer, E.M.; Bulgen, M.; Kampik, A. — Novel ocular lubricant containing an intelligent delivery system: details of its mechanism of action / Springs, C.
dear sir
i was diganoised with dry eye syndrome four years ago by mt doctor in scotland uk ,
over the period of these years have tried just about every lubrecation on the british books on this condition
my next thing on trying was my eye ducts to be capped ,which i was going to get next week , up until this i had no idea that other medications had been reconised and formed to hopefully cure this condition.
after speaking with a american eye specailist he suggested a drug called RESTASIS drops which im trying to get as much information about and find out if i can get them in uk , unfortunitly they are not avaible over here yet , can u please send me any more infomation concerning this drug and also where i can require this drop from
would be most grateful to any reply i recieve on this matter and may again thanks to taking the time to read and answer my query on this
yours faithfully
a. waddell
Dear Alex
Restasis is also not available here in Melbourne (Australia). It is, however, available in India where it is manufactured. Also cheaper than in USA, I gather, but not by much.
My understanding of this problem is growing as I read and learn more. It is not clear to me whether the average eye specialist is educated enough on the latest studies on this topic.
Punctal plugs will only help (in my current view) if you have evaporative dry eyes. The certain test of evaporative dry eyes (again, in my current view!) is the test for osmolarity. I’m getting my osmolarity tested next month since the machine (Tearlab osmolarity) has now come to Australia. What the punctal plug will do is increase osmolarity by reducing evaporation.
Since punctal plugs are reversible it seems it might be best to try them (in case you have evaporative dry eyes).
If the tear osmolarity is fine there still could be bacterial issues/ allergic issues/ mite issues (which the osmolarity machine can’t detect) which might be causing dry eye symptoms. These can’t be fixed using punctal plugs nor even with Restasis (in my view).
I’d recommend Mastik’s book Dry Eye Remedy as a starting point of your research. You definitely need to know the precise cause for only then can the treatment work.
Dont you mean punctual plugs will only work if you have aqeous defficiency? that is the understanding of everything ive read. I have evaporative dry eye and they didnt help me. Nor has anything else ive tried in the useless range of ''dry eye treatments'' out there.
S.Young, I'm a suffering patient trying to research and understand the logic of various things. Evaporative dry eye can have many causes, and if lachrymal gland dysfunction is not the cause I don't think punctal plugs can work. For instance if the mebimian glands aren't working, then all you'll get is toxic tears which can't be drained. Or if the underlying cause is allergy. And so on.
Yes that is my understanding.
Alex, you can get restasis from edrugnet.com with a prescription, it comes from thailand, i have ordered it myself and it is the real stuff, but with Thai instructions in the box as well as english.