Novel Treatment for Demodex Blepharitis Approved

HOT TOPIC

The FDA has approved lotilaner ophthalmic solution 0.25% (Xdemvy, Tarsus Pharmaceuticals) for the treatment of Demodex blepharitis. Xdemvy is the first FDA-approved treatment to directly target Demodex mites, which are the root cause of Demodex blepharitis.

Xdemvy is a topical eye drop that is applied to the eyelids twice daily for a 6-week treatment course. It works by killing Demodex mites. In clinical trials, Xdemvy was shown to be effective in reducing the number of mites and improving symptoms of Demodex blepharitis.

Image courtesy of Tarsus Pharmaceuticals.

In a conference call with investors, Tarsus Chief Commercial Officer Aziz Mottiwala said that Xdemvy will cost $1,850 for a 1-year prescription. The company plans to launch an assistance program to keep the cost at $100 or less for patients. Tarsus expects to receive commercial provider coverage in 2024 and Part D Medicare coverage in 2025.

In two randomized, multicenter, double-masked, vehicle-controlled studies (Saturn-1 and Saturn-2), patients with Demodex blepharitis saw improvement as early as 2 weeks, and the endpoint of mite eradication and lid erythema cure showed statistically significant improvement at day 43 in both studies. The studies also showed that Xdemvy was generally safe and well-tolerated, with the most common ocular adverse reactions being instillation site stinging and burning in 10% of patients. (Read more here.)

OUTSIDE THE LANE

Have Moxie, Will Triumph

Keryl Rustin, a 74-year-old woman from West Virginia, recently competed in her second National Senior Games 5K run. She finished the race in just 45 minutes and placed 15th in her age group, which is an incredible achievement, as Rustin is completely blind and has only recently taken up the sport of running. Typically, she runs a course with the assistance of her granddaughter, who provides cues on changes in the pavement or the road.

In last year’s National Senior Games, Rustin had planned on using a direction app on her phone to help guide her through the route. However, the app malfunctioned before the race, leaving her to run the race completely by herself. Amazingly, she completed the race by listening to the other runners’ footsteps and voices as they yelled directions at her during the race. This year, she ran with local runner Kenneth Lee (pictured below next to Rustin), who served as her guide.

Photo courtesy of National Senior Games.

My Two Cents

How often do we encounter patients who are frustrated with their visual issues? Notably, our patients with macular degeneration and diabetic retinopathy think their lives will be over as the disease progresses. Rustin is an inspiration to anyone who has ever faced a challenge and is a shining example of the human spirit overcoming an unfortunate situation.

CAN YOU RELATE

Last week, I mentioned how I had an extremely inconvenient conjunctivitis while on vacation. It got me thinking about what travel items are necessary for eye doctors as they take to the road, sky, or rails. Besides the obvious (extra contact lenses, lens solution, backup glasses, and artificial tears), what else should we keep on our person to be able to better handle any unexpected “events”?

Below are some additional items on my list.

• A combination steroid/antibiotic drop (for obvious reasons)
• A broad-spectrum antibiotic drop
• Hypochlorous acid (I like Bruder Hygienic Eyelid Solution—and keep in mind, hypochlorous acid has been found to be a safe and effective treatment for minor cuts and general wound cleansing)
• A disposable warm compress, like this one
• A preservative-free multidose bottle of lubricant eye drops, such as FreshKote Preservative Free (Santen) or Systane Complete Preservative-Free (Alcon)
• Single-use antihistamine drops, such as cetirizine ophthalmic solution 0.24% (Zerviate, Santen) or ketotifen fumarate ophthalmic solution 0.035% (Alaway Preservative Free, Bausch + Lomb)
• Spectacle cleaner/wipe and spectacle repair kit

Did I miss anything? Email me to let me know!

QUOTE OF THE WEEK

“The best and most beautiful things in the world cannot be seen or even touched — they must be felt with the heart.”

—Hellen Keller