A University of Sydney literature review found topical cyclosporine (CsA) treatment may be superior to the vehicle, artificial tears (AT) or other topical treatment alternatives for ocular surface disease (OSD). 

Writing in Clinical & Experimental Ophthalmology, researchers reviewed 48 randomised clinical trials comparing different concentrations of topical CsA with one or more topical treatments including AT, vehicle, Tacrolimus 0.03%, antiglaucoma drops, antibiotics plus steroid combination, diquafosol 3%, chloroquine phosphate and fluorometholone 0.1%. Of the 48 trials, 30 found significantly better efficacy with CsA, irrespective of dose or concentration. 

Results suggested a gr eater treatment effect with CsA 0.05% twice daily, alongside AT for dry eye disease, reported the research team. However, the certainty of the evidence was low to moderate and, since the majority of the reviewed trials were not more than one year in duration, the ability of clinicians to make informed decisions regarding OSD treatment is currently limited within that period, they said. “Notably, CsA was associated with a greater likelihood of discontinuations due to treatment-related adverse events.”