Lotilaner ophthalmic solution 0.25% in Demodex blepharitis: a profile of its use

Lotilaner ophthalmic solution 0.25% (XDEMVY®; henceforth referred to as lotilaner 0.25%) is a novel prescription eye drop indicated for the treatment of Demodex blepharitis. It is the first and currently the only US FDA-approved treatment for this condition. One drop of lotilaner 0.25% instilled in each eye twice daily for 6 weeks was associated with significantly higher rates of collarette reduction to ≤ 2 collarettes (primary endpoint), mite eradication and erythema cure compared to the vehicle control. Lotilaner 0.25% is generally well tolerated, with the most common ocular adverse reaction being instillation site stinging and burning (incidence 10%). The 6-week treatment remained durable with no safety issues during the observational period for up to a year. The eye drop was generally neutral or very comfortable for most patients. Demodex blepharitis is a common eyelid margin disease caused by an infestation of Demodex mites. It is characterized by persistent cylindrical waxy dandruff (collarettes) in the eyelashes, eyelid margin inflammation, redness and eye irritation. Lotilaner ophthalmic solution 0.25% (XDEMVY®; henceforth referred to as lotilaner 0.25%) is a novel prescription eye drop that eradicates Demodex mites. It is FDA-approved in the USA for the treatment of Demodex blepharitis. One drop of lotilaner 0.25% in each eye twice daily for 6 weeks significantly reduces collarettes, decreases or eradicates Demodex mites and reduces eyelid redness in patients with Demodex blepharitis. The treatment is generally well tolerated, with the most common ocular adverse reactions being installation site stinging and burning (incidence 10%). Currently, lotilaner 0.25% is the only US FDA-approved treatment for Demodex blepharitis.