Xiidra (Lifitegrast) Ophthalmic Solution: Treatment for Dry Eye Disease
Xiidra (lifitegrast) ophthalmic solution 5% is an FDA-approved medication specifically indicated for the treatment of both signs and symptoms of dry eye disease (DED). 1
Mechanism of Action
Lifitegrast works through a unique anti-inflammatory mechanism:
- Functions as a lymphocyte function-associated antigen-1 (LFA-1) antagonist 2
- Blocks the interaction between LFA-1 and its ligand intercellular adhesion molecule 1 (ICAM-1) 2
- This interaction normally contributes to T-cell activation and migration to target tissues 2
- By blocking this pathway, lifitegrast reduces inflammation on the ocular surface 1
Clinical Efficacy
Xiidra has demonstrated effectiveness in multiple clinical trials:
- Improves both signs of dry eye disease (corneal and conjunctival staining) 2
- Reduces symptoms of dry eye disease (eye dryness score and ocular discomfort) 2
- Benefits typically observed over a 3-month treatment period 2
- FDA approval was based on multiple phase 3 clinical trials showing statistically significant improvements compared to vehicle 1
Administration
The proper administration of Xiidra includes:
- One drop in each eye, twice daily (approximately 12 hours apart) 1
- Use immediately after opening the single-dose container 1
- Contact lenses should be removed prior to administration and can be reinserted 15 minutes after 1
- Discard the single-dose container after use 1
Safety Profile
Common side effects include:
- Eye irritation or discomfort when drops are applied 1
- Blurred vision (temporary) 1
- Unusual taste sensation (dysgeusia) 1
- Generally well-tolerated in long-term use up to 12 months 2
Place in Therapy
Xiidra is positioned in treatment algorithms for dry eye disease:
- Typically used when artificial tears and other first-line treatments provide inadequate relief 2
- Part of Step 2 treatment in the staged management approach for dry eye 2
- Can be used alongside other treatments for dry eye disease 2
- Represents one of the few FDA-approved prescription medications specifically for dry eye disease 2
Clinical Considerations
Important points for healthcare providers to consider:
- Xiidra treats both the signs and symptoms of dry eye disease, unlike some treatments that only address one aspect 1
- Long-term effects beyond 12 months are not fully established 2
- Particularly useful for patients with inflammatory components to their dry eye disease 2
- Should be stored at room temperature (20-25°C/68-77°F) in the original foil pouch to protect from light 1
Xiidra represents an important therapeutic option for patients suffering from dry eye disease, with a novel mechanism targeting the inflammatory pathways involved in this chronic condition.