No quantitative synthesis was attempted for either mebiomian plugging or meibomian secretion scores and no significant changes were observed with any other outcome parameter .
Conclusion : Only the systemic antimicrobials were found to improve the clinical features of meibomian gl and dysfunction .
Varying effects of different therapeutic agents ( heat therapies , omega-3-fatty acids and castor oil ) were identified for MGD but the risk of bias pertaining to r and omization and allocation concealment was found to be associated with most of the current RCTs .
Introduction : Meibomian Gl and Dysfunction ( MGD ) is a common , often overlooked , chronic condition affecting eyes for which various therapies are being evaluated .
Considering the absence of a systematic review and meta- analysis , the present review was carried out .
Topical interleukin 1 receptor antagonist for treatment of dry eye disease: a randomized clinical trial.
IMPORTANCE The immunopathogenic mechanisms of dry eye disease ( DED ) , one of the most common ophthalmic conditions , is incompletely understood . Data from this prospect i ve , double-masked , r and omized trial demonstrate that targeting interleukin 1 ( IL-1 ) by topical application of an IL-1 antagonist is efficacious in significantly reducing DED-related patient symptoms and corneal epitheliopathy . OBJECTIVE To evaluate the safety and efficacy of treatment with the topical IL-1 receptor antagonist anakinra ( Kineret ; Amgen Inc ) in patients having DED associated with meibomian gl and dysfunction . DESIGN AND SETTING Prospect i ve phase 1/2 , r and omized , double-masked , vehicle-controlled clinical trial . PARTICIPANTS Seventy-five patients with refractory DED . INTERVENTIONS Participants were r and omized to receive treatment with topical anakinra , 2.5 % ( n = 30 ) , anakinra , 5 % ( n = 15 ) , or vehicle ( 1 % carboxymethylcellulose ) ( n = 30 ) 3 times daily for 12 weeks . MAIN OUTCOMES AND MEASURES Primary outcomes were corneal fluorescein staining ( CFS ) , complete bilateral CFS clearance , dry eye-related symptoms as measured by the Ocular Surface Disease Index , tear film breakup time , and meibomian gl and secretion quality . RESULTS Topical anakinra was well tolerated compared with vehicle , with no reports of serious adverse reactions attributable to the therapy . After 12 weeks of therapy , participants treated with anakinra , 2.5 % , achieved a 46 % reduction in their mean CFS score ( P = .12 compared with vehicle and P < .001 compared with baseline ) ; participants treated with anakinra , 5 % , achieved a 17 % reduction in their mean CFS score ( P = .88 compared with vehicle and P = .33 compared with baseline ) ; and patients treated with vehicle achieved a 19 % reduction in their mean CFS score ( P = .11 ) . Complete bilateral CFS clearance was noted in 8 of 28 patients ( 29 % ) treated with anakinra , 2.5 % , vs in 2 of 29 patients ( 7 % ) treated with vehicle ( P = .03 ) . By week 12 , treatment with anakinra , 2.5 % , and treatment with anakinra , 5 % , led to significant reductions in symptoms of 30 % and 35 % , respectively ( P = .02 and P = .01 , respectively , compared with vehicle ) ; treatment with vehicle led to a 5 % reduction in symptoms . CONCLUSIONS AND RELEVANCE Treatment with topical anakinra , 2.5 % , for 12 weeks was safe and significantly reduced symptoms and corneal epitheliopathy in patients with DED . These data suggest that the use of an IL-1 antagonist may have a role as a novel therapeutic option for patients with DED . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00681109
No quantitative synthesis was attempted for either mebiomian plugging or meibomian secretion scores and no significant changes were observed with any other outcome parameter .
Conclusion : Only the systemic antimicrobials were found to improve the clinical features of meibomian gl and dysfunction .
Varying effects of different therapeutic agents ( heat therapies , omega-3-fatty acids and castor oil ) were identified for MGD but the risk of bias pertaining to r and omization and allocation concealment was found to be associated with most of the current RCTs .
Introduction : Meibomian Gl and Dysfunction ( MGD ) is a common , often overlooked , chronic condition affecting eyes for which various therapies are being evaluated .
Considering the absence of a systematic review and meta- analysis , the present review was carried out .