Meta-Analysis Finds Lotilaner Superior to Vehicle for Demodex Blepharitis

Treatment with lotilaner ophthalmic solution 0.25% was superior to vehicle/control for all Demodex blepharitis outcomes in a systematic review and meta-analysis published online in Cureus.

“Lotilaner marks the first approved groundbreaking antiparasitic treatment for Demodex blepharitis, a prevalent condition affecting the lid margin and significantly impacting patients on a psychological level,” wrote corresponding author Bakhtawar Awan, a resident physician at Northwick Park Hospital, London, England, and study coauthors. “It can completely cure the disease with a high safety profile.”

The analysis included a total 891 patients from four studies. Researchers investigated numerous safety and efficacy outcomes with lotilaner compared with the study vehicle, including clinically meaningful reduction in collarettes, collarette cure, composite cure, drop comfort, erythema cure, mite density, and mite eradication.

Clinically meaningful collarette reduction was approximately 3 times greater with lotilaner compared with the vehicle, according to the results. Incidences of collarette cure and composite cure were also higher with lotilaner: researchers reported risk ratios of 5.05 and 6.75, respectively. Additionally, mite density, mite eradication, and erythema cure outcomes were greater with lotilaner, with respective risk ratios of 2.58, 3.80, and 3.16.

There were no differences in drop comfort with lotilaner compared with control, the analysis found. Lotilaner was generally well tolerated, with no reported side effects compared with the vehicle.

“We recommend conducting direct comparative studies with alternative treatment modalities for a comprehensive evaluation of efficacy and safety,” researchers wrote.

Reference

Awan B, Elsaigh M, Tariq A, et al. A systematic review and meta-analysis of the safety and efficacy of 0.25% lotilaner ophthalmic solution in the treatment of Demodex blepharitis. Cureus. 2024;16(1):e52664. doi:10.7759/cureus.52664