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.