Point-of-Care Perspectives from PatientPoint

Another Attempt at Presbyopia

by PatientPoint

Last week saw the approval of a new therapeutic agent for presbyopia, Qlosi™, that will become available in the new year.

What is Qlosi™? 

This newest therapeutic called  Qlosi™, pronounced “CLOH-see,” from Orasis Pharmaceuticals®, is quite different from the previous therapeutic, Vuity®. While both are pilocarpine-based,  Qlosi™ has at least five differentiating factors. First, it is 1/3 the concentration of pilocarpine (0.4%) versus the previous drug at 1.2%. This alone may help minimize side effects and potential complications. Next, it launches with a BID dosing, where patients start one drop in the morning and then add the second around 2-4 hours later. This particular dosing in clinical studies showed a consistent 6-8-hour effect.1   

Other unique aspects of Qlosi™ include being preservative-free, which was not the case for previous versions. It also has a near-neutral pH in the bottle and thus on the eye, which has been a major issue for pilocarpine and is likely the cause of frequent burning or stinging upon installation. Beyond being preservative-free, it contains proprietary moisturizers that are effective in ocular surface disease. If you consider that the population using Qlosi™ will be above age 40, we’re likely to see more dry eye and meibomian gland dysfunction.  

These added moisturizers, no preservatives and a neutral pH should be significant benefits in comfort. Although there are no head-to-head studies with the previous presbyopia agent, Qlosi™ appears to have a longer duration, greater comfort.  

What have we learned from the previous presbyopia eye drop? 

Fortunately, we’ve learned a lot. The list includes not treating high myopes and expecting a more accurate 6-10 hours of effect with BID dosing. We’ve also learned it’s best to put the second dose in around 2-4 hours after the first rather than 10 or 12 hours later. We can set better expectations, such as the potential for dimming of vision or brow aches, and fortunately, this new agent appears to have a lower incidence of these. We’ve also learned that commercials stating “get rid of reading glasses” are over-promising, even though some patients truly experience this. Like Vuity, optometry is likely the top prescriber (82% of Vuity scripts) because that is where most patients reside.  

Patient education 

This is yet another time when patient education is essential for your patient’s success. They need to know that this medication does not provide magnification. I had patients who compared the drop results to their +2.00 readers (magnifiers) and were disappointed because the letters were larger with readers. This shows how important it is to educate these patients, as this new drop is not a magnifier. It works on extending the depth of focus. Lower myopes (-1.50 to -3.00) are another group that may not be the easiest to please as they can remove their glasses to see up close. So that leaves emmetropes, myopes under -1.25 and low/moderate hyperopes as the ideal category of patients. Fortunately, estimates suggest this category alone is well over 50 million people in the U.S. 

Educating patients with Exam Mode 

As part of my patient education strategy, I use software from Rendia, a PatientPoint company. Within their app, they have a feature called Exam Mode that lets me search “presbyopia”. You will instantly be guided to an entire page of materials, animations and patient education tools. The 90-second overview of presbyopia is precious, and I’d recommend playing this in the reception area. I even go into Exam Mode and click presbyopia under ‘Conditions”. This is a helpful animation that explains the condition in a very patient, friendly and effective manner, which I then emphasize with the POV tab. You can see that patients instantly relate to what you are showing. I truly feel that Rendia saves me more time in explaining presbyopia and the treatment options, including Qlosi™, in the future than practically any disease state. It’s time you can dedicate to so many other things in a clinical practice.

Learn how Rendia, a PatientPoint company, can help you educate your patients to improve care, adherence and outcomes.

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