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. 2025 Sep;14(9):2109-2124.
doi: 10.1007/s40123-025-01190-3. Epub 2025 Jul 10.

Real-World Experience with Lifitegrast Ophthalmic Solution in Patients with Dry Eye Disease: A Provider Survey in the USA and Canada

Cecelia Koetting  1 , Justin Schweitzer  2 , Kelly K Nichols  3 , Marguerite McDonald  4   5 , Christopher E Starr  6 , Clara C Chan  7 , Mile Brujic  8 , Louis Racine  9 , Francis S Mah  10 , Melissa Barnett  11 , Marjan Farid  12 , Eric D Donnenfeld  13 , Carolina Mercado  14 , Michelle Ratay  15 , Megan Cavet  16 , Robert Ryan  15 , Joel Fain  15 , Lisa K Feulner  17
Affiliations

Real-World Experience with Lifitegrast Ophthalmic Solution in Patients with Dry Eye Disease: A Provider Survey in the USA and Canada

Cecelia Koetting et al. Ophthalmol Ther. 2025 Sep.

Abstract

Introduction: Lifitegrast ophthalmic solution 5% is indicated to treat signs and symptoms of dry eye disease (DED). This study assessed eyecare professionals' (ECPs) real-world experiences with lifitegrast in DED.

Methods: A total of 12 ECPs (6 ophthalmologists and 6 optometrists) with experience prescribing lifitegrast completed a cross-sectional survey on practice characteristics, lifitegrast utilization, satisfaction, and adverse events (AEs). ECPs rated satisfaction with lifitegrast overall and for specific clinical outcomes versus other prescription eye drops on a 1 (very dissatisfied) to 10 (very satisfied) Likert scale.

Results: ECPs reported a mean of 1288 (range, 35-6000) patients with DED treated annually, with 20.9% receiving lifitegrast. Overall, 66.7% of ECPs reported near/complete symptom resolution in patients after 1-3 months of lifitegrast treatment. Mean (range) satisfaction ratings for onset/effectiveness were 6.8 (3-9)/6.6 (3-9). Satisfaction with reduction of DED signs was generally high: increased tear film breakup time, 5.8 (3-9); reduced conjunctival/corneal staining, 6.9 (3-9); increased Schirmer test score, 6.0 (3-9); increased tear meniscus height, 6.0 (3-9); and reduced Ocular Surface Disease Index severity, 7.0 (3-10). Symptom reduction satisfaction ratings were: itching, 5.3 (1-9); dryness, 6.9 (3-9); burning/stinging, 6.3 (1-9); redness, 6.2 (4-9); pain, 6.3 (3-9); light sensitivity, 6.5 (3-9); and blurred/poor vision, 6.8 (4-9). Overall satisfaction (ECPs/patients) was rated 7.1 (3-10)/6.8 (2-9). Predominant uses of lifitegrast included contact lens-induced DED (91.7%) and DED before/after refractive or cataract surgery (83.3% each). AEs reported were consistent with the known AE profile of lifitegrast and included burning/stinging, blurred vision, and dysgeusia.

Conclusions: This real-world survey showed that ECPs use lifitegrast to treat one fifth of their patients with DED and reported moderate-to-high personal and patient satisfaction with lifitegrast treatment.

Keywords: Cross-sectional survey; Drug utilization; Dry eye syndromes; Lymphocyte function-associated antigen-1; Physician satisfaction; Signs and symptoms.

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Conflict of interest statement

Declarations. Conflicts of Interest: Cecelia Koetting reports serving as a speaker, consultant, research, and/or advisory for Allergan/AbbVie, Alcon, Azura, Bausch + Lomb, Blinkjoy, Bruder, Dompe, Harrow, Myze, Orasis, PRN, Tarsus, Topcon Healthcare, Trukera Medical, and Viatris. Justin Schweitzer reports serving as a consultant or speaker for Alcon, Allergan/AbbVie, Bausch + Lomb, Bruder, Dompé, Glaukos, Iveric Bio, LKC Technologies, MediPrint Ophthalmics, Ocuphire Pharma, Reichert Technologies, ScienceBased Health, Sight Sciences, Sun Pharmaceutical Industries, Tarsus Pharmaceuticals, Théa, Topcon Healthcare, Trukera Medical, Visus Therapeutics, and Zeiss; and serving as Chief Medical Editor for Modern Optometry. Kelly K. Nichols reports receiving research funding from Aramis Biosciences, Kowa, ScienceBased Health, Sylentis, and TearScience; and serving as a consultant to and receiving honoraria from Allergan/AbbVie, Alcon, Aldeyra Therapeutics, Azura Ophthalmics, Bausch + Lomb, Bruder, Cavalry Biosciences, Dompé, HanAll Biopharma, Harrow, Novaliq, Novartis, Oyster Point Pharma (now Viatris), Sight Sciences, Sydnexis, Tarsus, TearSolutions, Théa, Topcon Healthcare, and Trukera Medical. Marguerite McDonald reports serving as a consultant to AbbVie, Alcon, Bausch + Lomb, Brill, Johnson & Johnson, Nordic Pharma, Ocuphire Pharma, Sun Pharma, Tarsus, and Trukera. Christopher E. Starr reports serving as a consultant to Alcon, Aldeyra Therapeutics, Allergan/AbbVie, Allgenesis, Amgen, Azura, Bausch + Lomb, BlephEx, Bruder Healthcare, CSI Dry Eye, Dompé, Èssiri, Eye Care International (ECI), Glaukos, Johnson & Johnson Vision, Kala Pharmaceuticals, Lumenis Be, Novaliq, Novartis, Nuvissa, Oculis, Oyster Point Pharma (now Viatris), Quidel, Sight Sciences, Sofia Biologics, Sun Pharmaceutical Industries, Tarsus, Thea Pharma, Trukera Medical, and Verséa Health; and having stock options in CSI Dry Eye, Sofia Biologics, and Nuvissa. Clara C. Chan reports serving on advisory boards, speakers bureaus, or as a consultant for AbbVie, Aequus Pharmaceuticals, Aurion Biotech, Bausch + Lomb, Johnson & Johnson, Kala Ophthalmics, Labtician Ophthalmics, Novartis, Santen Pharmaceutical, Sun Pharmaceutical Industries, Théa Pharma, and Valeo Pharma; and also has received research funding from Claris Bio and CorNeat. Mile Brujic reports serving as a speaker, consultant, researcher, and/or advisor, and received meeting support from ABB Optical Group, Alcon, Allergan/AbbVie, Art Optical, Bausch + Lomb Health, BlephEx, Contamac, CooperVision, CSEye, Dompé, Euclid, Eyevance Pharmaceuticals, Horizon Therapeutics, Johnson & Johnson Vision Care, Kala Pharmaceuticals, Luneau, Novartis, Optovue, Oyster Point Pharma, RVL, Sight Sciences, Sun Pharmaceutical Industries, Tangible Science, Tarsus, Viatris, Visionix, Walman Optical, and ZeaVision. Louis Racine reports serving on advisory boards, speakers bureaus, or as a consultant for Allergan, AbbVie, Alcon, Bausch + Lomb, Sun Pharmaceutical Industries, Théa Pharma, Staar Surgical, and Rayner Group. Francis S. Mah reports receiving grants from Allergan; reports personal fees from Shire/Takeda/Novartis; and being a consultant for Allergan, Eyevance Pharmaceuticals, Kala Pharmaceuticals, Novartis, and Sun Pharmaceutical Industries. Melissa Barnett reports serving on advisory boards or as a consultant, global ambassador, or speaker for ABB, AbbVie, Alcon, Azura Ophthalmics, Bausch + Lomb, BCLA, Bruder Healthcare, Bruno Vision, Cloudbreak Pharma, CooperVision, Dompé, Epion, Gas Permeable Lens Institute, Ocusoft, Orasis Pharmaceuticals, Percept, ScienceBased Health, Sjögren’s Foundation, STAPLE Program, Tarsus Pharmaceuticals, Théa Pharma, and Visus Therapeutics. Marjan Farid reports serving as a consultant for Bausch + Lomb and Johnson & Johnson Vision. Eric D. Donnenfeld reports serving as a consultant to Bausch + Lomb, Ocular Therapeutix, and Rayner; and reports receiving grants from Omeros. Carolina Mercado reports serving as a consultant to Bausch + Lomb. Michelle Ratay, Megan Cavet, Robert Ryan, and Joel Fain are employees of Bausch + Lomb. Lisa K. Feulner reports serving on advisory boards or as a consultant, global ambassador, or speaker for AbbVie, Alcon, Bausch + Lomb, Bruder Healthcare Company, Carl Zeiss Meditec, Inc., Glaukos, Regener-Eyes, Science Based Health, Sun Ophthalmics, Thea Pharma, and Tarsus Pharmaceuticals. Ethical Approval: This study was determined IRB-exempt by WCG IRB (Princeton, NJ, USA; IRB tracking ID 202425583). The study was exempt from IRB approval under 45 CFR § 46.104(d)(2) because the research only includes interactions involving survey procedures; and there are adequate provisions to protect the privacy of subjects and to maintain the confidentiality of data.

Figures

Fig. 1
Fig. 1
Primary reasons for prescribing lifitegrast. In response to the question, “What are your primary reasons for writing lifitegrast prescriptions?” ECPs were instructed to rank-order their top five responses (from 1 = most important to 5 = less important). A few participants provided and ranked more than five responses. aWritten responses to “other” included “prevent progression,” “indicated for both signs and symptoms,” and “Xiidra is uniquely beneficial in the context of allergic conjunctivitis”; ECP eyecare professional
Fig. 2
Fig. 2
Time to near/complete DED symptom resolution with lifitegrast treatment. In response to the question, “How long does it take for your patients to report nearly or complete resolution of the symptoms of DED after their first lifitegrast prescription?” DED dry eye disease, ECP eyecare professional
Fig. 3
Fig. 3
Eyecare provider satisfaction a with the effectiveness attributes of lifitegrast in response to the question, “Compared to other prescription eye drops for DED, how satisfied are you with the lifitegrast effectiveness attributes below?”; b with lifitegrast at improving the signs of DED in response to the question, “Compared to other prescription eye drops for DED, how satisfied are you with lifitegrast at improving the signs below?”; and c with lifitegrast at improving the symptoms of DED in response to the question, “Compared to other prescription eye drops for DED, how satisfied are you with lifitegrast at improving the symptoms below?” ECPs were instructed to circle on the Likert scale from very dissatisfied (1) to very satisfied (10); DED dry eye disease, ECP eyecare professional, OSDI Ocular Surface Disease Index
Fig. 4
Fig. 4
Overall provider satisfaction and provider-reported patient satisfaction with lifitegrast treatment. In response to the question, “Considering all aspects of your experience with lifitegrast, how would you rate:” ECPs were instructed to circle on the Likert scale from very dissatisfied (1) to very satisfied (10); ECP eyecare professional
Fig. 5
Fig. 5
Lifitegrast real-world usage pattern for DED associated with acute or chronic iatrogenic interventions. ECPs were instructed to choose all options that applied; DED dry eye disease, ECP eyecare professional, EK endothelial keratoplasty, LK lamellar keratoplasty, PK penetrating keratoplasty
Fig. 6
Fig. 6
Patient-reported improvements in quality of life. In response to the question, “Did your patients report any quality-of-life improvements following treatment with lifitegrast?” ECPs were instructed to choose all options that applied and rank-order them if more than one answer was checked; 1 indicated the most important; QOL quality of life
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