Efficacy and Safety of Lotilaner 0.25% Ophthalmic Solution for Treating Demodex Blepharitis: A Systematic Review

Abstract

Background: Blepharitis is a prevalent ocular disorder characterized by inflammation of the eyelid margins, with Demodex mite infestations being a significant contributor. Lotilaner, an FDA-approved antiparasitic from the isoxazoline class, offers a new therapeutic option by selectively targeting Demodex mites. Methods: A systematic review was conducted following PRISMA guidelines, focusing on studies published between 2014 and 2024. Results: Multiple studies demonstrated Lotilaner’s effectiveness in reducing Demodex mite density and symptoms of blepharitis. Key trials showed that collarette cure rates reached 81.3% by day 43, with mite eradication in 67.9% of patients, compared to placebo groups. These findings consistently highlight Lotilaner’s efficacy and favorable safety profile across diverse patient populations. Conclusion: Lotilaner 0.25% ophthalmic solution represents a significant advancement in treating Demodex-related blepharitis. While promising, further research is needed to confirm its long-term safety and comparative effectiveness against other therapies.