46 EyeWorld Asia-Pacific | September 2024 CORNEA Ophthalmologists have for years, had limited prescription options for patients experiencing dry eye and ocular surface disease. The number of available options have grown in the last decade, with several receiving approval in 2023. Now, a year later, Kenneth Beckman, MD, and Christopher Rapuano, MD, are sharing their thoughts and experiences with these new options, in addition to perspectives on where they fit in the growing ocular surface market. “I’m happy to have more options,” Dr. Rapuano said. “The truth is, we have tons of ocular surface disease patients who are not responding to the current treatments that we have. You do have to try different things. I personally prefer being able to choose from different options.” Vevye (cyclosporine ophthalmic solution, 0.1%, Novaliq) Vevye received FDA approval in June 2023 for treatment of signs and symptoms of dry eye. It is the third cyclosporine option in the ocular surface/dry eye market in addition to Restasis (cyclosporine ophthalmic emulsion, 0.05%, AbbVie) and Cequa (cyclosporine ophthalmic solution, 0.09%, Sun Ophthalmics). Dr. Rapuano said he doesn’t have direct experience with Vevye, but from what he understands, it seems to begin working at 4 weeks, while the other options take a little bit longer. Comparing Cequa and Restasis, Dr. Rapuano said that Vevye is approved for signs and symptoms of dry eye, whereas Cequa is indicated for increased tear production, and Restasis is indicated to increase tear production in patients with ocular inflammation associated with dry eye. by Liz Hillman, Editorial Co-Director Wish Granted: More Ocular Surface Options “This should mostly influence marketing considerations as far as I’m concerned,” Dr. Rapuano said. “The proof will be in the pudding; we’ll see whether it’s better than Restasis, Cequa, or Xiidra [lifitegrast ophthalmic solution, 5%, Bausch + Lomb]. Will it be less irritating? In my experience, Cequa is less irritating, and it’s better tolerated by patients than Restasis. Cequa is almost twice as strong as Restasis, so I do like it a lot. The downside is that it’s a newer medication, and it’s harder to get insurance coverage for it than for Restasis. Insurance coverage is better than it used to be, but it’s harder to get covered than Restasis.” Severe blepharitis with prominent collarettes sheathing the base of many of the eye lashes, indicative of Demodex mites. Source: Christopher Rapuano, MD
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