Abstract
Purpose :
Sjogren's Disease is an inflammatory condition affecting the exocrine glands that causes dry eye disease (DED). OC-01 0.03mg varenicline nasal spray (Tyrvaya, Oyster Point Pharma) is a FDA approved treatment for DED that functions as a cholinergic agonist to activate basal tear secretion. The purpose of this study was to determine if treatment with varenicline nasal spray improved the signs and symptoms of DED secondary to Sjogren's syndrome.
Methods :
A retrospective case series was conducted of patients with Sjogren's syndrome treated with varenicline nasal spray at the Scheie Eye Institute. Subjects were excluded if they did not have a follow-up visit or reported being non-compliant with treatment at their follow-up visit. Data including patient demographics, clinical exam findings, and symptoms evaluated by the Ocular Surface Disease Index (OSDI) were collected before and after prescription of the nasal spray.
Results :
Eighteen patients were included, with an average age of 59 years old (SD 15.1). 94% of patients were female and 6% male. The follow up time ranged from 2 to 8 months. Although not statistically significant, average OSDI scores trended down after initiation of treatment with varenicline nasal spray (40.1 versus 27.7, p=0.11). On evaluation of OSDI subscores, there was a statistically significant improvement in dry eye symptoms when using the computer (p=0.02) and symptoms in windy conditions (p=0.03). There was no statistically significant difference in visual acuity, intraocular pressure, lissamine green staining, or fluorescein staining after treatment. However, among the 22 eyes with Schirmer testing without anesthesia done at baseline and at follow-up, there was a statistically significant increase in tear production after treatment with the varenicline nasal spray (5.1 vs 6.6, p=0.005).
Conclusions :
We found that treatment with OC-01 0.03mg varenicline nasal spray was associated with a statistically significant improvement in tear production, as measured by Schirmer testing, in Sjogren’s Disease patients. Patients also trended towards decreased OSDI scores on follow up. Future larger prospective studies are needed to further evaluate the efficacy of varenicline nasal spray in improving the signs and symptoms of DED secondary to Sjogren’s, however this study helps provide supporting evidence for an alternative treatment that may be helpful for these patients.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.