FDA approves XDEMVY for treatment of Demodex blepharitis

Tarsus Pharmaceuticals Inc. today announced that the FDA approved lotilaner ophthalmic solution 0.25% for the treatment of Demodex blepharitis. (Image courtesy of Adobe Stock)

Tarsus Pharmaceuticals Inc. announced that the FDA approved lotilaner ophthalmic solution 0.25% (XDEMVY) for the treatment of Demodex blepharitis. Lotilaner ophthalmic solution 0.25%, formerly known as TP-03, is the first and only FDA approved treatment to directly target Demodex mites, the root cause of Demodex blepharitis.

“We are thrilled to announce the FDA approval of XDEMVY for the treatment of Demodex blepharitis and look forward to making this product broadly available to the millions of patients who have not had any FDA approved therapeutics for this disease,” Bobak Azamian, MD, PhD, CEO and chairman of Tarsus, said in a news release. “This tremendous milestone was achieved through a successful collaboration of our talented Tarsus team, countless eye care providers and the hundreds of patients who participated in our trials. We are grateful and honored for the opportunity to introduce the first and only approved therapeutic for this disease to the eye care community.”

According to the company’s news release, the FDA approval is based on results from two randomized, multicenter, double-masked, vehicle-controlled studies (Saturn-1 and Saturn-2), designed to evaluate the safety and efficacy of XDEMVY in 833 patients, 415 of which received lotilaner ophthalmic solution. Patients with Demodex blepharitis were randomized to either lotilaner ophthalmic solution or vehicle at a 1:1 ratio and dosed twice daily in each eye over the course of 6 weeks.

The company noted that efficacy was demonstrated by a significant improvement in eyelids (reduction of collarettes, the pathognomonic sign of the disease, to no more than 2 collarettes per upper lid) in each study by Day 43, with some patients seeing improvement as early as 2 weeks. Additionally, the endpoints of mite eradication (mite density of 0 mites per lash) and erythema cure (Grade 0) showed statistically significant improvement at Day 43 across both studies. In clinical trials, XDEMVY was generally safe and well tolerated. The most common ocular adverse reactions observed in the studies were instillation site stinging and burning which was reported in 10% of patients. Other ocular adverse reactions reported in less than 2% of patients were chalazion/hordeolum (stye) and punctate keratitis.

Neda Shamie, MD, co-chief medical editor of Ophthalmology Times, a cataract, LASIK and corneal surgeon at Maloney-Shamie Vision Institute, participated in the clinical trials for lotilaner ophthalmic solution.

“Xdemvy is the first in class treatment for Demodex blepharitia and will most definitely have a significant impact on our patients and our approach to patient care in our practice moving forward,” Shamie said. “Demodex blepharitia can exacerbate ocular surface inflammation, meibomian gland disease, dry eyes, and other yet to be discovered associations with comorbidities. I am grateful for the hard work, diligence and dedication of the team that brought this approval to fruition and am excited to offer this treatment to patients.”

Christopher Starr, MD, associate professor of Ophthalmology, director of Refractive Surgery, Ophthalmic Education and the Cornea Fellowship Program at Weill Cornell Medicine, New York Presbyterian Hospital, pointed out in the news release that after years of seeing Demodex blepharitis in his practice without an effective way to target the root cause of the disease, he is now happy to have a new treatment to offer his patients.

“Demodex blepharitis, easily diagnosed by the presence of eyelash collarettes, can result in ocular damage in multiple ways, including irritation, eyelash distention or loss and inflammation, which can be uncomfortable for patients,” he said in the news release. “This new medicine is a positive step forward for the treatment of this disease in many patients who have been struggling for years.”

Demodex blepharitis impacts approximately 25 million eye care patients in the U.S. – or 1 out of every 12 adults. It is a common yet often misdiagnosed or underdiagnosed eyelid disease that is caused by an infestation of Demodex mites, the most common ectoparasite found on human skin. Demodex blepharitis is characterized by redness, inflammation, missing or misdirected eyelashes, horizontal itching along the eyelid base and the presence of collarettes. Collarettes are cylindrical, waxy debris of mite waste products and eggs found at the base of the eyelashes.

“More than half of the patients in my practice present with Demodex blepharitis, and to date, we’ve not had any FDA approved therapies to treat the disease,” Selina McGee, OD, FAAO, BeSpoke Vision, said in the news release. “Many patients have experienced redness, crusting and overall ocular discomfort for years and I am excited to finally be able to offer an FDA-approved treatment for my patients.”

For more information about lotilaner ophthalmic solution and full prescribing information, please visit www.xdemvy.com.