Discover what's new in topical drugs

The key to treating any disease is to know your enemy before engaging in the battle.

Key Points

The key to treating any disease is to know your enemy before engaging in the battle. Even with the evolved understanding in the ophthalmic industry, ocular pathogens adapt quickly to the numerous efforts to fight them. Thus, the anti-infective and anti-inflammatory methods of treatment are constantly challenged to keep pace.

New drug classes, synthetic non-antibiotic anti-infectives, and combination drugs provide the topical anti-infective and anti-inflammatory pipeline with many possibilities for treating diseases in ways that were previously impossible.

Anti-infective formulations

Another promising ophthalmic compound is FST-100 (Foresight Biotherapeutics), a combination povidone-iodine and dexamethasone ophthalmic suspension that targets the dual clinical needs of microbial eradication and reduction in inflammation associated with ocular infections.

FST-100 is currently in development for the treatment of adenoviral conjunctivitis.1 Povidone-iodine (PVP-I) is a well-characterized broad-spectrum antiseptic that works by iodination of lipids and oxidation of cytoplasmic and membrane compounds and may provide antimicrobial activity with no known risk of microbial resistance. One pilot study concluded that FST-100 showed efficacy in reducing both the inflammatory and infectious components in patients who tested positive for adenoviral antigen.2

One drug advancing in the pipeline of therapeutics for local delivery in ocular disease is ESBA105 (ESBATech). ESBA105 is a single-chain antibody fragment directed against TNF-alpha, a major mediator of inflammation.3 ESBATech has initiated a phase IIa study in patients with acute anterior uveitis4 and a phase Ib/IIa study in patients undergoing cataract surgery.5 Preclinical studies have shown that topically administered ESBA105 reaches therapeutic levels in the anterior and posterior segment and shows potential for clinical use to treat TNF-alpha dependant diseases of the eye.6