And then there were three.

Sun Pharma has officially launched Cequa

What is it?

It’s cyclosporine 0.09%. It was FDA approved back in August of 2018, but is now available to prescribe.

How is this different than Restasis?

Two main ways: the concentration and the vehicle in which cyclosporine is delivered.
1. Restasis is cyclosporine 0.05%, so Cequa is a stronger concentration of the drug.
2. Cequa’s vehicle is a “nanomicellular formulation,” which allows for better penetration through the aqueous layer.

Tell me about the clinical trials.

More than 1,000 patients were included in the two trials (phase 2/3 and phase 3). Patients were given either Cequa or the vehicle for 12 weeks. After 12 weeks of treatment, Cequa showed an improvement in Schirmer score. Researchers also found that 65% of central corneas were clear from staining at 3 months. More info on the clinical trial results here

Does it work faster than Restasis?

According to the results, yes. The company states that “improvements in ocular staining assessments were seen as early as 1 month after initiating treatment.”

What is the dosing?

Cequa’s dosing is BID and packaged in single-use, preservative-free vials.

Any side effects?

The biggest ones were pain on instillation (22%) and redness (6%).

And the most important question…how much does it cost?

The cost, of course, depends on commercial versus private insurance. Read the details on that here and learn about the Cequa Support Specialty Pharmacy, which can help with benefits verification and prior auths here


How important is it that I keep my AMD follow-up appointments?

According to a new study, very. 

Tell me about the study.

A research team at Wills Eye Hospital studied the sociodemographic factors of patients who present with wet AMD. Specifically, they wanted to know whether these factors influence presenting VA. The study examined more than 3,200 patients with newly diagnosed wet AMD.

What were some study highlights?

The authors found the odds of severe vision loss at initial wet AMD presentation were greater among:
- Patients with regional adjusted gross income of $50,000 or less.
- Non-white patients compared with white patients.
- Patients without previous follow-up for dry AMD. These patients were 2.25 times more likely to have severe vision loss on initial presentation than those with a history of dry AMD follow-up.

Why is a patient’s presenting VA so important?

Because prior studies have shown that patients with wet AMD who have better baseline VA at the time of treatment initiation achieve better post-treatment VA.

The take home:

This study found that older age, non-white race, decreased regional adjusted gross income, and no prior history of follow-up for dry AMD were associated with a severe reduction in VA at initial presentation of wet AMD.


We have a new optical illusion to love/hate.

Meet the gray-and-teal shoe vs pink-and-white shoe

Want to be a better driver?

Get cataract surgery. New research shows having cataract surgery can make you 48% safer on the road. (via)

Editor’s note: As an additional comment to the Beovu story from last week, Eylea is also approved for 12-week dosing.

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