Study: Who are the autologous serum "responders"?
I LOVE THIS STUDY!
(Of course, I tend to love everything published in The Ocular Surface. But some things excite me more than others.)
My initial point of excitement about this particular abstract was its opening sentence:
Autologous serum eye drops (ASEDs) are used worldwide to treat dry eye disease (DED).
Think of what it took to get to this place!
SO much research, SO many stories, SO much effort to spread the word. This was a stock part of conversations I had with an awful lot of dry eye patients for maybe 15 years: “Could you talk to your eye doctor about autologous serum drops?” The reason it was so slow, of course, is that it wasn’t a drug or device, therefore there weren’t any marketing dollars propelling awareness. That’s the primary mechanism for dry eye treatments to become known. In the case of autologous serum, I believe a great deal of increased awareness amongst ophthalmologists has been due to PATIENTS asking about it, which is really a triumph of internet information and social media powering individual self-advocacy.
The point of the study: 68% of patients were autologous serum “responders”, and we need to learn more about who is and who isn’t.
A retrospective analysis of characteristic features of responder patients to autologous serum eye drops in routine care. Levy et al, Ocul Surf. 2019 May 16
Autologous serum eye drops (ASEDs) are used worldwide to treat dry eye disease (DED). However, the biological composition of ASEDs has not been well investigated, and effectiveness predictive factors remain to be identified. The main objective of this study was to compare the response of patients treated with ASEDs biologically characterized and used for DED routine care.
This retrospective observational study was conducted in a single university hospital, and included 50 patients (87 eyes) with DED refractory to conventional treatment and resulting from various etiologies with Ocular Surface Disease Index (OSDI) ≥ 20. Each patient used eight drops a day per treated eye with 20% diluted ASEDs. Undiluted serum extensive biological characterization were performed, and symptoms were recorded before the initiation of ASEDs and closer to the sixth month of treatment. Responders were defined as presenting an improvement from baseline ≥14 points in OSDI and/or ≥1 grade in corneal fluorescence staining for all eyes treated.
The OSDI and the Oxford scale were significantly reduced from 68.7 ± 23.2 to 54.8 ± 25.7 and 3.2 ± 1.5 to 2.1 ± 1.3 (p ≤ 0.0001), respectively. A total of 68% of the patients were responders. Nonresponding patients had significantly higher epidermal growth factor concentrations in the serum compared to responders (p = 0.017).
ASED administration resulted in significant clinical improvement in the management of DED. Biological differences observed between responders and nonresponders suggested that a better understanding of the biological activity of ASEDs is still required.