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Possible new treatment for dry eye syndrome

A drug used to treat rheumatoid arthritis may one day provide relief for people with a painful eye condition called dry eye syndrome, a study has found.
By Grant Stewart

BMJ Group News

What do we know already?

woman receiving eye exam

Dry eye syndrome, also known as keratoconjunctivitis sicca, is one of the most common reasons people seek help from eye specialists ( ophthalmologists). It happens when the eyes don’t make enough tears or when the tears dry too quickly because the oil glands that help to keep the eyes moist are blocked or don’t work properly. It can cause symptoms such as pain, blurred vision, burning, watering, and the feeling that you have something in your eye. For some people these symptoms can be so severe as to affect their work and other aspects of their lives.

Dry eye syndrome affects about 3 in 100 people overall, but it is more common among middle-aged and older people. It can be caused by a number of things, including being in a hot or windy climate, hormonal changes in the body, getting older, or as a side effect of some medicines.

Dry eye syndrome is often treated with anti-inflammatory eye drops that help reduce swelling in the eyes and the oil glands. But these don’t suit everyone, and can cause side effects such as burning, pressure in the eyes, and even cataracts. So researchers are looking at other medicines that could treat the symptoms without causing so many problems.

In one study, researchers looked at a medicine called anakinra, which is often used by people with rheumatoid arthritis to reduce swelling in painful joints. The researchers wanted to see whether it could also reduce the swelling and other symptoms of dry eye syndrome. They randomly divided 75 people with dry eye syndrome into three groups. People in the first two groups were given eye drops containing different strengths of anakinra, while the third group was given plain eye drops containing no medicine (called ‘vehicle’ drops). None of the people in any of the groups knew which drops they had been given.

What does the new study say?

After 12 weeks, people in both of the groups given anakinra said that their symptoms had been reduced on average by 30 percent to 35 percent (about a third). People given the plain ‘vehicle’ drops said their symptoms had improved by only five percent (one twentieth). Side effects with anakinra were no worse than with the ‘vehicle’ drops.

How reliable is the research?

This type of study, called a randomised controlled trial, is the best kind of research for finding out how well treatments work when compared with each other. When neither the people in the trial nor the researchers know who has taken what, no one can influence the results.

But this was a very small trial - far too small to say for sure whether this treatment really works. It also only compared anakinra against a dummy treatment (the ‘vehicle’ drops), so we don’t know how well it might work compared with other medicines.

What does this mean for me?

For the moment you won’t be able to try anakinra if you have dry eye syndrome. But that could change if more trials find that it works well. In the meantime there are other treatments. You can also do things to help yourself, such as keeping your eyes clean and protecting them from dry, windy conditions. If you have symptoms such as sensitivity to light, very red or painful eyes, or worsening vision, you should see your doctor straight away.

Published on April 25, 2013

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