P2Y2 receptor agonists for the treatment of dry eye disease: a review

Abstract

Oliver C F Lau,1 Chameen Samarawickrama,1,2 Simon E Skalicky1–31Sydney Eye Hospital, Sydney, NSW, Australia; 2Save Sight Institute, University of Sydney, Sydney, NSW, Australia; 3Ophthalmology Department, Addenbrooke's Hospital, Cambridge, United KingdomAbstract: Recent advances in the understanding of dry eye disease (DED) have revealed previously unexplored targets for drug therapy. One of these drugs is diquafosol, a uridine nucleotide analog that is an agonist of the P2Y2 receptor. Several randomized controlled trials have demonstrated that the application of topical diquafosol significantly improves objective markers of DED such as corneal and conjunctival fluorescein staining and, in some studies, tear film break-up time and Schirmer test scores. However, this has been accompanied by only partial improvement in patient symptoms. Although evidence from the literature is still relatively limited, early studies have suggested that diquafosol has a role in the management of DED. Additional studies would be helpful to delineate how different subgroups of DED respond to diquafosol. The therapeutic combination of diquafosol with other topical agents also warrants further investigation.Keywords: dry eye disease, meibomian gland disease, aqueous tear deficiency, diquafosol, P2Y2 agonists