Real-world experience of using ciclosporin-A 0.1% in the management of ocular surface inflammatory diseases

Deshmukh, Rashmi, Ting, Darren Shu Jeng, Elsahn, Ahmad, Mohammed, Imran ORCID: https://orcid.org/0000-0002-8412-0768, Said, Dalia G and Dua, Harminder Singh 2022. Real-world experience of using ciclosporin-A 0.1% in the management of ocular surface inflammatory diseases. British Journal of Ophthalmology 106 , pp. 1087-1092. 10.1136/bjophthalmol-2020-317907

PDF - Published Version Available under License Creative Commons Attribution Non-commercial. Download (314kB)

Abstract

Purpose To report the real-world experience of using topical ciclosporin, Ikervis, in the management of ocular surface inflammatory diseases (OSIDs). Methods This was a retrospective study of patients treated with Ikervis for OSIDs at the Queen’s Medical Centre, Nottingham, between 2016 and 2019. Relevant data, including demographics, indications, clinical parameters, outcomes and adverse events, were collected and analysed for patients who had completed at least 6 months follow-up. For analytic purpose, clinical outcome was categorised as ‘successful’ (resolved or stable disease), ‘active disease’ and ‘drug intolerance’. Results 463 patients were included; mean age was 51.1±21.6 years, with a 59.0% female predominance. Mean follow-up was 14.6±9.2 months. The most common diagnosis was dry eye disease (DED; 322, 69.5%), followed by allergic eye disease (AED; 53, 11.4%) and ocular mucous membrane pemphigoid/Steven-Johnson syndrome (OMMP/SJS; 38, 8.2%). Successful treatment was achieved in 343 (74.1%) patients, with 44 (9.5%) requiring additional treatment and 76 (16.4%) reporting drug intolerance. The efficacy of Ikervis was highest in DED (264, 82.0%), followed by OMMP/SJS (25, 65.8%) and post-keratoplasty (7, 50.0%; p<0.001). Logistic regression analysis demonstrated age <70 years (p=0.007), AED (p=0.002) and OMMP/SJS (p=0.001) as significant predictive factors for Ikervis intolerance. AED and post-keratoplasty were 8.16 times (95% CI, 2.78 to 23.99) and 13.98 times (95% CI, 4.22 to 46.28), respectively, more likely to require additional treatment compared with DED. Conclusions Ikervis is a useful steroid-sparing topical treatment for managing OSIDs in the real-world setting. Preparations with improved tolerability are needed to benefit a larger number of patients.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Optometry and Vision Sciences
Additional Information:	This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0)
Publisher:	BMJ Publishing Group
ISSN:	0007-1161
Date of First Compliant Deposit:	3 October 2022
Date of Acceptance:	1 February 2021
Last Modified:	02 May 2023 12:36
URI:	https://orca.cardiff.ac.uk/id/eprint/152687

Citation Data

Cited 7 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item