Eye drops may reverse early cataracts

Hello Health Rounds readers! Today we have promising data on experimental eye drops for cataracts and a nasal spray to ease the symptoms of a crippling lung disease. We also report on a study of pregnancies after uterus transplants.

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Experimental eye drops may become the first drug treatment for early cataracts, according to data from a small analysis.

Presently, no treatment can improve vision in patients whose cataracts are not advanced enough to be surgically removed.

Cataracts form when proteins in the lens of the eye start to break down and clump together, creating a cloudy area on the lens. The C-KAD eye drops from Los Gatos, California-based Livionex, with 2.6% ethylenediaminetetraacetic acid disodium (EDTA) as the active ingredient, penetrate the eye to break up the degraded protein complexes forming the cataract.

“If we can stop (a cataract) before it starts or treat it in the early stages, then it sets an entirely new trajectory in patient eye care,” Livionex CEO Amit Goswamy said in a statement.

Participants in the study all had early age-related cataracts, with some loss of contrast sensitivity but normal or only minimally impaired visual acuity. They used the drops four times a day for 120 days, according to the study in the American Journal of Ophthalmology.

Comparing 21 eyes treated with the eye drops and 20 eyes treated with a placebo, the treated eyes had significantly greater improvements in vision – particularly in distinguishing subtle differences in contrast – and in lens transparency, with no serious adverse events, the researchers said.

“Cataract therapy using eye drops has the potential to have a global public health impact, because while cataract surgery is safe, 51% of world blindness is due to cataracts, and there aren’t enough ophthalmologists to do cataract surgery, even if it was free,” Dr. Roy Chuck of Albert Einstein College of Medicine in New York, a study co-author, said in a statement.

An experimental nasal spray dramatically reduced troublesome coughing episodes in patients with a disabling lung disorder that affects more than 3 million people worldwide, researchers said.

Daily coughing episodes were reduced by 73.2% in patients with idiopathic pulmonary fibrosis who had been randomly assigned to use Flemington, New Jersey-based EmphyCorp’s nonsteroidal N115 spray for three weeks, compared to a reduction of 16.1% in patients treated with a placebo, according to a study in the European Journal of Respiratory Medicine.

Patients with idiopathic pulmonary fibrosis have progressively worsening lung scarring for no detectable reason, resulting in stiffness in the lungs that makes it difficult to breathe.

The spray, containing sodium pyruvate, was administered three times a day along with any other medications patients were taking.

Patients treated with N115 also reported improvements in breathing, sleep quality and fatigue. In addition, they had improvements in a range of parameters measured by lung function tests, according to the study.

When patients were contacted by phone after the study ended, those in the treatment group said the reduction in coughing had lasted nearly 39 days, on average, compared to only about six days in the placebo group.

EmphyCorp said that in earlier trials in patients with allergic and chronic rhinitis, N115 was superior to placebo for improving nasal inflammation and congestion.

The company has been granted Orphan Drug status, supporting the development of new treatments for rare diseases, by the U.S. Food and Drug Administration to develop N115 for the treatment of cystic fibrosis.

Uterus transplants allow for pregnancy and childbirth in women without a functioning uterus, a new study showed.

Doctors at Baylor University Medical Center in Dallas reviewed the outcomes of 20 women, ages 20 to 36, with so-called uterine-factor infertility and at least one functioning ovary who received a transplanted uterus, or womb, between 2016 and 2019.

The transplant procedures were successful in 14 of the women. All 14 later gave birth to at least one baby for a total of 16 live-born infants, the doctors reported in JAMA. Among those 16, there were no congenital malformations.

Complications occurred in 50% of the successful pregnancies, with the most common being pregnancy-related high blood pressure, cervical insufficiency and preterm labor.

Eighteen of the uteruses were from living donors, four of whom had medical or surgical complications after the organ donation.

All of the uterus recipients eventually had the organs removed, to avoid the need for lifelong immunosuppression therapy for preventing rejection.

An editorial accompanying the study noted that the costs involved in transplantation are extraordinary, and differential access to fertility treatments “due to high costs of care are present not only for breakthrough treatments such as uterus transplant, but even for widely accepted treatments like IVF.”

The study “presents an opportunity to reflect on how patients access care for infertility in general, not just for elite and breakthrough treatments such as uterus transplant,” wrote the editorial authors, Dr. Jessica Walter and Dr. Emily Jungheim, both of Northwestern University in Chicago.

This newsletter was edited by Will Dunham; additional reporting by Shawana Alleyne-Morris.

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