Real-world study shows burden of Demodex blepharitis and how lotilaner ophthalmic solution, 0.25% can be effective
Kendall Donaldson, MD, a professor of clinical ophthalmology at the Bascom Palmer Eye Institute in Miami, discussed the findings of a study presented at the American Society of Cataract and Refractive Surgery Annual Meeting that found treatment of Demodex blepharitis with lotilaner improved patient outcomes.
Kendall Donaldson, MD:
Today I’ll be talking about basically a study I’ll be presenting at the ASCRS meeting next week. We’ll be reviewing the results of the Orion study, which is basically covering the impact of Demodex blepharitis in a longitudinal fashion, looking at the symptoms that patients have over time. We follow the patients for a 6-month period through a series of surveys, basically at baseline, 1 month, 3 months, and 6 months, looking at the severity of symptoms and how they change over time with the treatment.
We know from prior studies, including the Titan study, that Demodex blepharitis is very common in our everyday clinical practices of ophthalmology. We also know that almost all patients are symptomatic from Demodex blepharitis; 99% of patients have some type of symptom that is associated with Demodex blepharitis, including redness of the eyes and lids, itching, irritation, and a lot of these patients are self-medicating with warm compresses or artificial tears, and they’re generally ineffective, and the patients continue to suffer with these symptoms long-term.
Basically, the Orion study just looks at the incidence of these various symptoms that the patients are having over time at baseline. Then, throughout treatment, however, this is a retrospective analysis, so no actual treatment is instituted, but we compare patients who are on lotilaner to patients who are just using artificial tears and more compresses. We look at the incidence of symptoms over time in a retrospective fashion.
We did notice that at baseline, actually, the Demodex blepharitis patients who are treated with lotilaner are actually more symptomatic than patients who are not treated with lotilaner. But that may be because doctors are more likely to treat someone who has more symptoms. Those patients tend to get treated in a higher frequency. But over time, the patients that were treated with lotilaner have a lessening of their symptoms. They are less likely to increase their usage of artificial tears and that type of thing. They tend to use less of those other types of treatments over time. But at 1 month, 3 months, and 6 months, the symptoms continued to improve. The patients had less redness; they had less ocular irritation.
The findings were very interesting in that way. But again, this is a longitudinal retrospective analysis. Just looking at the real-life analysis of what these patients are experiencing over time.
This study included 300 patients at 20 different sites around the country. It was very diverse at different practice settings. It is interesting to see how many different types of symptoms Demodex blepharitis patients have. We looked at many different types of symptoms and then categorized them in more specific details, but they’re really 15 to 20 different symptoms that the patients have of different types of ocular surface symptoms. Then we kind of boiled them down to the top 8 that were most significant to patients. But all of those symptoms really improved with treatment. It was very interesting to watch how those symptoms decreased over time.
It’s interesting Demodex blepharitis really affects so many of us and so many of our patients. If we really take a closer look into the patients that are in our clinics, even if they’re coming in for other types of illnesses or diseases, our patients that come in with glaucoma or macular degeneration or for various types of serious corneal problems, a lot of them also have Demodex blepharitis. We may be overlooking that, particularly in some of our patients, like our glaucoma patients who often suffer from various severe ocular surface disease.
Sometimes we just need to make a note of it and take a closer look and use that opportunity to treat these patients a little bit more effectively so they can be more comfortable, while also undergoing treatment for other types of conditions as well.
In summary, our patients are really suffering from Demodex blepharitis, and I think a lot of times we may not even take note of those symptoms unless we really look more closely at the lids, have patients look down, and really take the opportunity to treat these patients because we now have a very, very effective treatment to offer our patients. We should take this opportunity to help them be more comfortable, have whiter eyes, and really eradicate a Demodex blepharitis in our patients.
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