Maniabilité et acceptabilité du flacon Abak® nouvelle génération chez des patients traités au long cours. Étude transversale, rétrospective et multicentrique

Squeezability of eye drop containers used in dry eye disease management

CLINICAL RELEVANCE

Ocular lubricants are the mainstay of dry eye management and are available in a variety of formulations and bottle designs. The squeezability of ocular lubricant bottles may influence administration and compliance.

BACKGROUND

A key component for managing dry eye disease is the use of ocular lubricants. The different bottle types, each with their unique material strength and dispensing mechanism, may be challenging for patients with limited hand and pinch strength. The aim of this study was to evaluate the force required to expulse a drop from different eye drop containers used in the management of dry eye disease.

METHODS

The force, in newtons (N), required to expulse a drop from different eye drops was evaluated five times using a force gauge, and divided by bottle type, i.e. tubes, unidose, multidose with preservatives, and multidose preservative free (MDPF) bottles.

RESULTS

Sixty (n = 60) bottles were examined with 57 eye lubricants and 3 dry eye medications (cyclosporine (0.5% and 0.9%), and lifitegrast). The average force varied depending on the bottle type (tubes 4.28 ± 1.29 N; unidose 14.24 ± 4.83 N; multidose 16.62 ± 5.21 N; MDPF 26.68 ± 8.32 N, p < 0.001). Post-hoc test revealed that MDPF bottles required more force than all other bottle types (p < 0.001), and among those, the ophthalmic squeeze dispenser bottle required significantly more force (p < 0.001). Lifitegrast required more force (17.38 ± 2.13 N) than cyclosporine 0.5% (9.16 ± 0.80 N, p < 0.024) and cyclosporine 0.9% (5.68 ± 0.40 N, p < 0.001), but was not significantly different from unidose ocular lubricants (p > 0.05).

CONCLUSION

The squeezability of bottles used in dry eye disease management varies with bottle type. Hand and pinch strength should be considered when choosing products for dry eye disease management, as the squeezability of an ophthalmic drop can influence its administration and compliance.

Topical preservative-free ophthalmic treatments: an unmet clinical need

Introduction: The main role of preservatives in eyedrops is to ensure sterility and microbiological integrity of the drug, and to facilitate the penetration of active compounds into the eye. However, several studies documented significant toxic effects induced by preservatives, especially on the ocular surface. Consequently, most of the ophthalmic medications became progressively available in preservative-free (PF) formulations.Areas covered: We analyzed pre-clinical and clinical studies on PF eyedrops with particular attention to common chronic diseases such as dry eye and glaucoma. We discussed about the pros and cons of using PF eyedrops, in terms of efficacy, safety, and social-economic aspects.Expert opinion: There are still unresolved issues that make hard for PF medications to definitively conquer the drug market. Despite robust pre-clinical evidences of less toxicity, the low number of randomized clinical trials does not permit to state that PF eyedrops have, in clinical practice, a similar efficacy or a higher safety compared to preserved forms. These aspects limit their use to chronic diseases requiring long-term therapies with multiple daily instillations, especially in the presence of concomitant ophthalmic diseases that expose to a risk of ocular surface worsening.

European real-world data about the use of a new delivery system containing a preservative-free multi-dose glaucoma treatment

Background

Glaucoma treatments are mostly presented in uni-dose or multi-dose format. A certain number of patients with visual acuity and dexterity problems may have problems in instilling eye drops.

Aim

To assess patient satisfaction and ease of use of a preservative-free glaucoma treatment (dorzolamide/timolol) in a new and innovative patented multi-dose delivery system.

Methods

Retrospective, international, multicentre, non-interventional study in 788 adult patients using a multi-dose delivery system for at least 28 days.

Results

Mean patient age was 68.1 ± 12.1 years. Mean duration of multi-dose delivery system use was 132.1 ± 125.1 days; 66.5% of the patients previously used multi-dose and 33.5% uni-dose delivery systems (n = 734); 78.3% of the patients were satisfied or very satisfied with the multi-dose delivery system. A significant majority (all p ≤ 0.045) of patients with a QuickDash® score between [0 to 25[ (66.4%, n = 211) and [50 to 75[ (81.8%, n = 11) rated multi-dose delivery system as easy or very easy to open and significantly more subjects in the [0 to 25[ (72%) score group rated multi-dose delivery system as being better or much better than their previous device (n = 211). Significantly (all p < 0.01) more subjects with available visual acuity results rated multi-dose delivery system as good, better or much better than their previous dispensing device.

Conclusion

The tested multi-dose delivery system was highly accepted. It is, therefore, suitable for glaucoma patients with decreased visual acuity and/or dexterity problems. Further studies may be necessary to assess the easiness of use of this easy-to-grip delivery system.

Use of preservative-free hyaluronic acid (Hylabak(®)) for a range of patients with dry eye syndrome: experience in Russia

Artificial tear preparations are important in the management of dry eye syndrome. We present the findings from four recently published studies conducted in Russia assessing Hylabak(®) (marketed as Hyabak(®) in Europe), a preservative-free hyaluronic acid preparation, for the treatment of dry eye syndrome. All studies had an open, noncomparative design, but one compared the findings with those from 25 patients treated with Tear Naturale(®) in previous studies. A total of 134 children and adults were enrolled, and the etiologies of dry eye syndrome included contact lens use, intensive office work, adenovirus eye infection, postmenopausal status, persistent meibomian blepharitis, Sjögren's syndrome, phacoemulsification with intraocular lens implantation, and refractive surgery. The patients were treated with Hylabak for 2 weeks to 2 months. All studies showed that Hylabak resulted in marked improvement as assessed by subjective sensations/complaints, Schirmer's test, Norn's test, impression cytology and biomicroscopy, staining, and tear osmolarity. Greater benefits were also reported compared with Tear Naturale, including a faster onset of action. Hylabak was well tolerated. In conclusion, Hylabak provided rapid and safe relief from the signs and symptoms of dry eye syndrome, as well as improvement in objective measures, in a wide range of patients.