Effect Of Topical IL-1RA On Signs And Symptoms Of Dry Eye Disease In Patients With Ocular Graft-versus-host Disease (GVHD)

Abstract

Purpose: : To evaluate the effect of off-label use of topical interleukin-1 receptor antagonist (IL-1Ra) on symptoms and corneal flourescein staining in patients with dry eye disease due to ocular GVHD.

Methods: : Retrospective review of 74 eyes (37 subjects) treated with off-label topical IL-1Ra drops three times a day for 12 weeks was performed. Symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Corneal Flourescein Staining (CFS) was evaluated using the modified Oxford grading system. Symptom scores and average CFS of both eyes were compared to baseline values.

Results: : At baseline mean OSDI score was 48±23 and mean CFS score was 2.1±1. Patients show statistically significant change beginning at 6 weeks for OSDI (p=0.001) and 2 weeks for CFS (p<0.05). After completing 12 weeks of treatment, patients showed a statistically significant improvement in OSDI (40±26, p=0.01) and CFS (1.4±0.8, p<0.001) compared to baseline values. Interestingly, the group of patients with severe symptoms at baseline (OSDI>33) achieved a mean reduction of 18±23 (p<0.001) in OSDI score at week 12.

Conclusions: : Treatment with topical IL-1Ra significantly reduces symptoms (OSDI) and corneal flourescein staining in patients with ocular GVHD and dry eye disease.

Keywords: cornea: tears/tear film/dry eye • clinical (human) or epidemiologic studies: outcomes/complications • cytokines/chemokines