OBJECTIVES: Dry eye disease (DED) causes chronic ocular surface inflammation and damage. DED prevalence increases with age. Cyclosporine ophthalmic solution 0.09% (CEQUA^®; OTX-101), cyclosporine ophthalmic emulsion 0.05% (Restasis^®; CsA), and lifitegrast ophthalmic solution 5% (Xiidra^®; LFT) are anti-inflammatory agents indicated for DED treatment. We compared treatment patterns in patients >64 years with DED receiving OTX-101, CsA, or LFT.

METHODS: This retrospective, longitudinal cohort study utilized Symphony Health Integrated Dataverse claims from 07/2019–06/2021. Study included all patients with OTX-101 claims, and patients with CsA or LFT claims selected 2:1 to OTX-101. Follow-up was from first treatment claim (05/2020–06/2021) to end of clinical activity/data availability. Patients were ≥18 years at first treatment claim, with ≥1 DED diagnosis from 07/2019–06/2021 and ≥1 additional treatment claim within 4 months after first claim. This analysis compared time to treatment discontinuation (TTD) and probability of discontinuation in a subset of patients >64 years (overall median age at first treatment claim).

RESULTS: Overall, 3344 patients (OTX-101, n=761; CsA, n=1268; LFT, n=1315) >64 years were eligible. OTX-101 and CsA patients >64 years were 27% more likely to discontinue treatment than OTX-101 and CsA patients ≤64 years (P=0.007). Median TTD (95% confidence interval; CI) was 275 days (225–not estimable), 208 days (194–241), and 269 days (235–313) for OTX-101, CsA, and LFT, respectively. Median treatment duration (95% CI) for OTX-101 was 67 days (275–208) longer than for CsA. Differences in Kaplan-Meier TTD were statistically significant for OTX-101 vs CsA per log rank test (P=0.002) but not for OTX-101 vs LFT (P=0.624).

CONCLUSIONS: OTX-101 and CsA patients >64 years were significantly more likely to discontinue treatment than those ≤64 years. Patients >64 years receiving OTX-101 remained on treatment significantly longer than those on CsA; time on treatment was similar for OTX-101 and LFT.