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Dry
eye
disease
compounds…

A
critical
point
to
highlight
is
that
all
of
the
above-­-mentioned
potential
new
drugs

are
centering
their
action
mainly
towards
symptoms,
controlling
inflammation
or

restoring
the
normal
amount
of
tears
but
none
of
them
is
addressing
the
causative

mechanisms
of
the
disease
leaving
its
cause
unattended.
Developing
a
new
drug
for

the
treatment
of
DED
has
become
a
key
target
for
the
pharmaceutical
industry.

Even
though
dry
eye
is
the
most
widespread
eye
disorder,
there
is
limited
offer
of

effective
therapeutic
agents.
Dry
eye
disease
is
not
a
life-­-threatening
disorder
and

its
symptoms
are
not
severe,
but
the
overarching
complexity
of
the
syndrome

makes
it
challenging
to
manage.
Many
of
the
candidate
dry
eye
agents
are
failing

FDA
testing,
even
though
some
of
them
are
approved
in
Asia
and
Europe,
mainly

because
of
the
tight
clinical
trials
regulations
in
the
USA.
Other
reasons
for
this

frequent
failure
are
the
nature
of
the
syndrome
and
the
lack
of
an
objective
test
for

the
diagnosis
of
the
severity
of
the
disease,
because
usually
symptoms
evaluation

is
insufficient
as
a
measurement
factor.
There
are
several
proposals
for
new,

objective
tests
such
as
molecular
markers
(94,
95)
and
tear
film
osmolarity
tests

(96,
97)
but
at
the
moment
none
of
them
has
advanced
beyond
the
pre-­-clinical

evaluation.
Dozens
of
companies
have
placed
under
development
a
vast
variety
of

new
drug
candidates
in
their
pharmaceutical
pipelines
and
most
of
these
drugs

have
already
approved
as
treatment
for
other
diseases
as
identical
biological

pathways
can
be
active
in
different
ways
in
various
diseases.
Discovering
new
uses

for
old
drugs
can
ensure
important
financial
benefits,
for
patients
as
well
as
for

biotechnology
companies,
lowering
costs
and
shortening
the
approval
timelines.

ACKNOWLEDGMENTS

We
would
like
to
thank
the
Spanish
Ministry
of
Economy
and
Competition

(Project
SAF2010-­-16024)
and
the
Ministry
of
Health
Social
Services
and
Equality

(Project
RETICS
RD12/0034/0003)
for
their
funding
contribution
to
this

publication.

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