• Dry Eye? New Nasal Spray May Increase Tear Production


    A recently approved nasal spray may enable ophthalmologists to help dry eye patients by increasing their basal tear production, Marjan Farid, MD, reported Sunday.

    Varenicline (Tyrvaya, Oyster Point Pharma) is a cholinergic agonist that demonstrated an effect on tear production within five minutes of dosing in clinical trials, said Dr. Farid.

    In her presentation, Dr. Farid summarized the clinical trial results that led to FDA approval of varenicline last month. Those studies, with more than 1,000 participants, showed statistically significant increases in tear production after four weeks of twice-daily dosing with the nasal spray, Dr. Farid reported.

    The most common adverse reaction was mild sneezing, in 82% of participants. Other adverse events, also mild, were cough, throat irritation, and instillation-site (nasal) irritation, in 5% to 16%.

    “Its very exciting to have this novel mechanism of action to treat patients with dry eye disease,” Dr. Farid said. “This nasal spray can restore the tear film homeostasis early on and, hopefully, prevent a lot of patients from having a chronic hyperosmolarity state that leads to more chronic inflammatory issues down the road.

    “I think I will definitely use it as more of a first-line therapy for early to moderate dry eye patients who dont yet need anti-inflammatories and see if I can restore their tear film homeostasis,” she said. —Linda Roach

    Financial disclosures: Dr. Farid: Allergan: C; Bausch + Lomb: C; Bio-Tissue, Inc.: C; CorneaGen: C; Dompe: C; Johnson & Johnson Vision: C; KALA: C; Novartis, Alcon Pharmaceuticals: C; Sun Ophthalmics: C; Tarsus: C; Zeiss: C.

    Disclosure key. C = Consultant/Advisor; E = Employee; L = Lecture Fees; O = Equity Owner; P = Patents/Royalty; S = Grant Support.