Point-of-Care Perspectives from PatientPoint

MIEBO Approved

by Paul M. Karpecki, OD

The first of several new therapeutics was FDA-approved in 2023. What should we know about this topical drug for the signs and symptoms of dry eye disease, and how can Rendia, a PatientPoint company, assist in educating our patients?

MIEBO™ (100% perfluorohexyloctane), which had the study drug name of NOV03, is an important new treatment option that specifically targets tear evaporation, a leading cause of dry eye disease (DED)

Research shows it can inhibit evaporation about ten times greater than healthy meibum. Intertwining with a patient’s existing lipid layer and compensating or filling deficient gaps creates an anti-evaporative layer that lasts 4-6 hours with little to no blur.

Perfluorohexyloctane was found to reside in meibomian glands for more than 24 hours. It was approved with a QID dosing schedule.

The FDA approval of MIEBO was based on results from two randomized, multi-center, double-masked, saline-controlled studies (GOBI and MOJAVE) that involved 1,217 patients randomized between MEIBO or hypotonic saline 0.6%. This was the first and only phase 3 program for any FDA-approved prescription DED product composed entirely of patients who had DED with clinical signs of MGD.

Contraindications include contact lens wearers, and the FDA recommends waiting 30 minutes after using MIEBO to insert your contact lenses. The most common adverse events were blurred vision and redness in 1-3% of patients.

Approximately 86% of all dry eye involved MGD or evaporation. Excessive tear evaporation is a leading driver of DED, and triggers increased ocular inflammation and desiccative stress, damaging the ocular surface. Treating evaporation as the underlying source of DED could help break the cycle of chronic disease and help restore ocular surface homeostasis.

Patient education on dry eye that sticks

I like to use Rendia’s Exam Mode to teach patients about dry eye, with MGD being the most common cause; I quickly focus on the eyelids and, specifically, the images of the meibomian glands. I do this in Exam Mode by quickly mentioning the lacrimal glands above and the MGs in the lower eyelid as I click on the plus over the lower lid. I then click “Blink” under functions to show the vertical meibomian glands and explain how the blink pushes out the meibum and how lack of blinking (i.e., digital device use) can contribute to increased evaporation of tears. Another option is to click “Tear Flow,” which shows the tears coming out of the MGs with a similar explanation. In addition, you can click on the “Dry Eye” and/or dry eye POV in the “Conditions tab” to help the patient understand that evaporation can cause redness, inflammation and/or blurred vision.

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

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