PMID- 37452334
OWN - NLM
STAT- MEDLINE
DCOM- 20230717
LR  - 20230718
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 23
IP  - 1
DP  - 2023 Jul 14
TI  - The efficacy and safety of varenicline nasal spray for the management of dry eye 
      signs: a systematic review and meta-analysis.
PG  - 319
LID - 10.1186/s12886-023-03069-y [doi]
LID - 319
AB  - BACKGROUND: Dry eye disease (DED) is caused by a persistently unstable tear film 
      leading to ocular discomfort and is treated mainly with tear supplementation. 
      There is emerging evidence that nicotinic acetylcholine receptor (nAChR) agonists 
      (e.g., varenicline and simpinicline) nasal sprays are effective for DED. Our 
      systematic review and meta-analysis assessed the efficacy and safety of 
      varenicline nasal spray (VNS) for DED treatment. METHODS: The Medline, Embase, 
      and Cochrane Central Register of Controlled Trials (CENTRAL) databases were 
      searched. Only randomized controlled trials (RCTs) that evaluated the efficacy of 
      VNS versus placebo were included. The efficacy endpoint was the mean change in 
      the anesthetized Schirmer test score (STS), a measure of basal tear production, 
      from baseline. The safety endpoints were serious adverse events (SAEs) and 
      adverse events (AEs). The standardized mean difference (SMD) was used for 
      continuous outcomes, while the risk ratio (RR) was used to demonstrate 
      dichotomous variables. The certainty of the evidence was rated utilizing the 
      Grading of Recommendations Assessment, Development, and Evaluation (GRADE) 
      approach. The risk of bias assessment was conducted using the Revised Cochrane 
      risk of bias tool for randomized trials. RESULTS: Three RCTs (n = 1063) met the 
      eligibility criteria. All RCTs had a low risk of bias. The meta-analysis found a 
      statistically significant increase in the mean STS change from baseline on day 
      28. The pooled analysis found no significant difference between VNS and placebo 
      in the frequency of SAEs and ocular AEs. However, VNS had a significant effect on 
      developing nasal cavity-related AEs. CONCLUSION: VNS caused a highly significant 
      improvement regarding the efficacy endpoint but caused an increased frequency of 
      some nasal cavity-related AEs (i.e., cough and throat irritation). However, it 
      caused neither SAEs nor ocular AEs. Included studies had a low risk of bias.
CI  - (c) 2023. The Author(s).
FAU - Bashrahil, Bader
AU  - Bashrahil B
AD  - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 
      Jeddah, Saudi Arabia. Badrbashrahil@gmail.com.
AD  - King Abdullah International Medical Research Center, Jeddah, Saudi Arabia. 
      Badrbashrahil@gmail.com.
FAU - Taher, Nada
AU  - Taher N
AD  - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 
      Jeddah, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
FAU - Alzahrani, Ziyad
AU  - Alzahrani Z
AD  - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 
      Jeddah, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
FAU - Alnabihi, Ahmed
AU  - Alnabihi A
AD  - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 
      Jeddah, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
FAU - Aldahlawi, Abdulaziz
AU  - Aldahlawi A
AD  - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 
      Jeddah, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
FAU - Alkhathlan, Mohammed
AU  - Alkhathlan M
AD  - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 
      Jeddah, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
FAU - Alghamdi, Saeed
AU  - Alghamdi S
AD  - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 
      Jeddah, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
AD  - Department of Ophthalmology, Ministry of the National Guard-Health Affairs, 
      Jeddah, Saudi Arabia.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20230714
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
RN  - 0 (Nasal Sprays)
RN  - W6HS99O8ZO (Varenicline)
SB  - IM
MH  - Humans
MH  - *Nasal Sprays
MH  - Varenicline
MH  - *Dry Eye Syndromes/drug therapy
PMC - PMC10347795
OTO - NOTNLM
OT  - Dry eye disease
OT  - Nasal spray
OT  - Varenicline
COIS- The authors declare no competing interests.
EDAT- 2023/07/15 10:42
MHDA- 2023/07/17 06:42
PMCR- 2023/07/14
CRDT- 2023/07/14 23:36
PHST- 2022/09/29 00:00 [received]
PHST- 2023/07/03 00:00 [accepted]
PHST- 2023/07/17 06:42 [medline]
PHST- 2023/07/15 10:42 [pubmed]
PHST- 2023/07/14 23:36 [entrez]
PHST- 2023/07/14 00:00 [pmc-release]
AID - 10.1186/s12886-023-03069-y [pii]
AID - 3069 [pii]
AID - 10.1186/s12886-023-03069-y [doi]
PST - epublish
SO  - BMC Ophthalmol. 2023 Jul 14;23(1):319. doi: 10.1186/s12886-023-03069-y.