NICE has today published preliminary recommendations on ciclosporin (Ikervis, Santen Pharmaceutical) for treating severe keratitis in adults with dry eye disease which has not improved despite treatment with artificial tears, and has asked for more information from the company.

Dry eye disease is chronic inflammation of the eyes caused by reduced tear production or excessive tear evaporation. It can be triggered by a number of factors, including dry or air-conditioned environments, auto-immune diseases (such as rheumatoid arthritis, and lupus), and the adverse effects of some medications. Symptoms include irritation and redness in the eyes, blurred vision, and a sensation of grittiness or a foreign body in the eye.

The independent Appraisal Committee noted that it had not been presented with evidence on the relative cost and clinical effectiveness of ciclosporin compared with established clinical practice. The Committee concluded that it needed additional evidence from the company to inform its decision-making, which should include:

• An indirect comparison of the clinical effectiveness of ciclosporin plus corticosteroids (if needed) and artificial tears, and that of corticosteroids (if needed) and artificial tears.
• An economic model comparing the cost effectiveness of ciclosporin plus corticosteroids (if needed) and artificial tears, with that of corticosteroids (if needed) and artificial tears.

For more details, go to: http://www.nice.org.uk/news/press-and-media/nice-consults-on-dry-eye-treatment-and-asks-for-more-information-from-the-company