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How to Prescribe

Demodex blepharitis (DB):
Seeing the root of the problem

Checking for DB is as simple as having your patient look down

during a routine slit lamp exam1

What is Demodex blepharitis?

DB is a common eyelid margin disease caused by an overgrowth of Demodex mites and characterized by collarettes, eyelid redness, inflammation, and ocular irritation.2,3

All images are of real patients diagnosed with Demodex blepharitis.

Demodex mites are the most common ectoparasite in humans, and Demodex folliculorum inhabits the eyelash follicles2,3
Two-thirds of blepharitis cases are associated with Demodex mites1,*
DB is highly prevalent but underdiagnosed1,4
~56% (n=245/440) of patients with cataracts have DB1
  60% (n=135/225) of patients treated for dry eye also have DB1
~93% (n=26/28) of patients with soft contact lens intolerance were found to have Demodex5,†

*STUDY DESIGN: A retrospective chart review for DB by 7 investigators at 6 eye care clinics of the case records of patients (N=1032) who underwent a slit lamp examination, regardless of chief complaint.

†In a study of people who used soft contact lenses (N=62) for a period exceeding 6 months, individuals who reported discomfort while wearing their contact lenses (n=28) were compared with others who reported no discomfort (n=34). The aim of the study was to identify any relationship between the incidence of Demodex mites in the eyelash hair follicles of patients using soft contact lenses and the abandonment of these lenses by their users.

DB LID LIBRARY

IMAGE CREDIT
Renee Bovelle, MD
IMAGE CREDIT
Marc Bloomenstein, OD
IMAGE CREDIT
Albert Chenug, MD
IMAGE CREDIT
Selina McGee, OD
IMAGE CREDIT
Brandon Ayres, MD
IMAGE CREDIT
Joshua Davidson, OD
IMAGE CREDIT
Neda Shamie, MD
IMAGE CREDIT
Vin Dang, OD
IMAGE CREDIT
Renee Bovelle, MD
IMAGE CREDIT
Selina McGee, OD
IMAGE CREDIT
Himani Goyal, MD
IMAGE CREDIT
Elizabeth Yeu, MD
IMAGE CREDIT
Renee Bovelle, MD
IMAGE CREDIT
Marc Bloomenstein, OD
IMAGE CREDIT
Albert Chenug, MD
IMAGE CREDIT
Selina McGee, OD
IMAGE CREDIT
Brandon Ayres, MD
IMAGE CREDIT
Joshua Davidson, OD
IMAGE CREDIT
Neda Shamie, MD
IMAGE CREDIT
Vin Dang, OD
IMAGE CREDIT
Renee Bovelle, MD
IMAGE CREDIT
Selina McGee, OD
IMAGE CREDIT
Himani Goyal, MD
IMAGE CREDIT
Elizabeth Yeu, MD

Inflammation from DB can cause a domino effect and can be a complicating factor in the management of overall eye health2,6

MITE ANATOMY

The external digestion of Demodex mites can lead to eyelid irritation2
Demodex mites cause microscopic epithelial abrasions7
Demodex mites transport bacteria on their surface and in their gut2,8
Collarettes are cylindrical, waxy deposits of mite waste products, keratinized cells, and eggs found at the base of the eyelashes.2,3

Slit lamp examination,
10x magnification

Slit lamp examination,
10x magnification

Slit lamp examination,
10x magnification

Keep an eye out for collarettes

  • Collarettes are the pathognomonic sign of DB1,2
  • Have patients look down during a routine slit lamp examination1
  • If you see collarettes, then you can confidently diagnose DB9

Delivering the diagnosis

Nobody loves talking about mites on their eyelashes, but it’s important to assure patients that DB is:

  1. Very common and not their fault1,4
  2. Caused by microscopic mites getting a bit out of hand1,9
  3. Easy to effectively treat10

of patients with collarettes have Demodex mites9

XDEMVY HCP Home Page

Learn how to give your patients
might over mites

About XDEMVY

The first and only FDA-approved
treatment for Demodex blepharitis

References: 1. Trattler W, Karpecki P, Rapoport Y, et al. The prevalence of Demodex blepharitis in US eye care clinic patients as determined by collarettes: a pathognomonic sign. Clin Ophthalmol. 2022;16:1153-1164. 2. Fromstein SR, Harthan JS, Patel J, Opitz DL. Demodex blepharitis: clinical perspectives. Clin Optom (Auckl). 2018;10:57-63. 3. Rhee MK, Yeu E, Barnett M, et al. Demodex blepharitis: a comprehensive review of the disease, current management, and emerging therapies. Eye Contact Lens. 2023;49(8):311-318. 4. O’Dell L, Dierker DS, Devries DK, et al. Psychosocial impact of Demodex blepharitis. Clin Ophthalmol. 2022;16:2979-2987. 5. Tarkowski W, Moneta-Wielgoś J, Młocicki D. Demodex sp. as a potential cause of the abandonment of soft contact lenses by their existing users. Biomed Res Int. 2015;2015:259109. 6. Aumond S, Bitton E. The eyelash follicle features and anomalies: a review. J Optom. 2018;11(4):211-222. 7. Luo X, Li J, Chen C, Tseng S, Liang L. Ocular demodicosis as a potential cause of ocular surface inflammation. Cornea. 2017;36(Suppl 1):S9-S14. 8. Bitton E, Aumond S. Demodex and eye disease: a review. Clin Exp Optom. 2021;104(3):285-294. 9. Gao YY, Di Pascuale MA, Li W, et al. High prevalence of Demodex in eyelashes with cylindrical dandruff. Invest Ophthalmol Vis Sci. 2005;46(9):3089-3094. 10. XDEMVY [prescribing information]. Tarsus Pharmaceuticals, Inc; 2023.

INDICATIONS AND USAGE
XDEMVY (lotilaner ophthalmic solution) 0.25% is indicated for the treatment of Demodex blepharitis.

IMPORTANT SAFETY INFORMATION:

WARNINGS AND PRECAUTIONS

Risk of Contamination: Do not allow the tip of the dispensing container to contact the eye, surrounding structures, fingers, or any other surface in order to minimize contamination of the solution. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions.

Use with Contact Lenses: XDEMVY contains potassium sorbate, which may discolor soft contact lenses. Contact lenses should be removed prior to instillation of XDEMVY and may be reinserted 15 minutes following its administration.

ADVERSE REACTIONS: The most common adverse reaction with XDEMVY was instillation site stinging and burning which was reported in 10% of patients. Other ocular adverse reactions reported in less than 2% of patients were chalazion/hordeolum and punctate keratitis.

To report SUSPECTED ADVERSE REACTIONS, contact Tarsus Pharmaceuticals, Inc. at 1-888-421-4002 or the FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).

Please see full Prescribing Information.

INDICATIONS AND USAGE
XDEMVY (lotilaner ophthalmic solution) 0.25% is indicated for the treatment of Demodex blepharitis.

IMPORTANT SAFETY INFORMATION:

WARNINGS AND PRECAUTIONS

Risk of Contamination: Do not allow the tip of the dispensing container to contact the eye, surrounding structures, fingers, or any other surface in order to minimize contamination of the solution. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions.