Pharmaceutical Business review

NICE recommends use of Santen’s IKERVIS in England to treat severe keratitis

IKERVIS is the first and only topical ciclosporin preparation licensed for the treatment of severe keratitis in patients with dry eye disease in the UK.

It is estimated that 61,000 adults in England and Wales suffer from the severe form of dry eye disease. Symptoms of dry eye disease include burning, itching and dryness, gritty sensation and photophobia. Severe keratitis is an inflammation of the cornea, which can result from dry eye disease.

It is a distressing condition for patients and has a very significant impact on their well-being and quality of life. Severe keratitis in patients with dry eye disease presents another major challenge: patients may present with signs of serious ocular surface damage but their symptoms may not correlate to the clinical signs, making diagnosis difficult. However, inflammation if left untreated can lead to further complications, permanent corneal damage and even loss of sight.

Professor Figueiredo, Professor of Ophthalmology at Newcastle’s Royal Victoria Infirmary and Newcastle University, said, "NICE’s positive appraisal of Ikervis means that UK patients with severe keratitis and dry eye disease will have access for the first time to a licensed product with the potential to have a significant positive impact.

"Patients with this particularly unpleasant and disabling condition have a seriously impaired quality of life, and patients often have been unable to access licensed treatment that they need. Ophthalmologists now have a new and licensed treatment option that could make a real difference to our patients"

Ciclosporin works by reducing inflammation in dry eye disease. However, until the launch of IKERVIS, there has been no topical preparation of ciclosporin licensed in the UK. IKERVIS has a novel cationic nano-emulsion formulation to effectively deliver the anti-inflammatory potential of ciclosporin.

With this recommendation from NICE, IKERVIS provides an important new option for the treatment of patients in England who have not responded to tear substitutes. In October of this year the Scottish Medicine’s Consortium (SMC) determined that IKERVIS should be made available to patients in Scotland.

The NICE decision was based on data from the SANSIKA trial. This was a double-masked multicentre, randomised, vehicle-controlled six month pivotal phase III trial with a six month open label treatment safety follow up period, which evaluated the efficacy and safety of IKERVIS, administered once daily in adult patients with severe dry eye disease.

Key evidence from SANSIKA showed that IKERVIS with once-daily dosing, reduces ocular surface inflammation and reduces corneal damage, and is consistent with an improvement in patients’ disease severity.