Division of Cornea and External Disease, Kellogg Eye Center (A.Y.T.), University of Michigan, Ann Arbor, MI; Department of Ophthalmology (S.F.P.), Duke University Eye Center, Durham, NC; and Division of Cornea and Refractive Surgery (P.K.G.), Department of Ophthalmology, Duke University Eye Center, Durham, NC.
Eye Contact Lens. 2020 Jan;46 Suppl 1:S20-S24. doi: 10.1097/ICL.0000000000000601.
To evaluate the clinical characteristics, outcomes, and adverse reactions after the use of lifitegrast 5% ophthalmic solution for the treatment of patients with dry eye disease (DED).
Retrospective chart review was performed in 121 patients seen at the Duke Eye Center with DED who were prescribed lifitegrast 5% and seen for follow-up after treatment initiation. Charts were reviewed for meibomian gland dysfunction (MGD) grading, conjunctival and corneal staining scores, and tear breakup time (TBUT), as well as matrix metalloproteinase-9 (MMP-9) levels. Ocular Surface Disease Index (OSDI) questionnaire scores and self-reported adverse reactions were also assessed.
The average patient age was 60.5 years (range, 22-88 years); 87.6% were female, and 20.7% had a previous autoimmune disease diagnosis. Of the 54 eyes with an initial positive MMP-9, 21 eyes (38.9%) normalized after treatment. The ocular symptoms OSDI subscore demonstrated an improvement of -2.43±6.85 (P=0.011) after treatment. Corneal staining scores showed an average change of -0.15 (P=0.007). The average change in TBUT was 1.9 sec (P<0.001). Self-reported adverse reactions were noted in 31.4% of patients. There was no statistically significant change in MGD grading. Patients with moderate-severe DED showed statistically significant improvements in conjunctival and corneal staining scores and TBUT (-0.17±0.66, P=0.0442; -0.54±0.65, P<0.001; +2.02±2.63, P=0.004, respectively).
Lifitegrast 5% is a useful therapeutic option for DED with a moderate proportion of self-reported adverse reactions, all of which were related to ocular discomfort. Treatment with lifitegrast was associated with statistically significant improvements in MMP-9 levels, ocular symptoms, corneal staining, and TBUT.
评估利福平 5%滴眼溶液治疗干眼症（DED）患者的临床特征、结局和不良反应。
对在杜克眼科中心就诊的 121 例接受利福平 5%治疗并在治疗后进行随访的 DED 患者进行回顾性图表审查。评估了睑板腺功能障碍（MGD）分级、结膜和角膜染色评分以及泪膜破裂时间（TBUT），以及基质金属蛋白酶-9（MMP-9）水平。还评估了眼表疾病指数（OSDI）问卷评分和自我报告的不良反应。
患者平均年龄为 60.5 岁（范围，22-88 岁）；87.6%为女性，20.7%有既往自身免疫性疾病诊断。在最初 MMP-9 阳性的 54 只眼中，21 只（38.9%）在治疗后正常化。治疗后，眼部症状 OSDI 亚评分改善了-2.43±6.85（P=0.011）。角膜染色评分平均变化为-0.15（P=0.007）。TBUT 平均变化 1.9 秒（P<0.001）。31.4%的患者报告了不良反应。MGD 分级无统计学显著变化。中重度 DED 患者的结膜和角膜染色评分和 TBUT 均有统计学显著改善（-0.17±0.66，P=0.0442；-0.54±0.65，P<0.001；+2.02±2.63，P=0.004）。
利福平 5%是治疗 DED 的有效治疗选择，有相当比例的患者报告了不良反应，所有不良反应均与眼部不适有关。利福平治疗与 MMP-9 水平、眼部症状、角膜染色和 TBUT 的统计学显著改善相关。
