An update on emerging pharmacological treatments for meibomian gland dysfunction

Introduction: Meibomian Gland Dysfunction (MGD) represents the most common cause of dry eye disease (DED). Traditional treatments mainly rely on heating and liquifying the meibum to favor its expression. However, recent knowledge advances have led to the development of novel therapies specifically designed for patients with MGD. Areas covered: Literature search was conducted on current and novel treatments for MGD. Conventional treatment strategies, non-pharmacological approved device-based therapies, approved dry eye therapies and both recently approved and emerging pharmacological treatments specifically designed to address MGD are discussed. Expert opinion: The better understanding of MGD and DED pathophysiology has allowed to develop drugs able to target the primary mechanisms of the disease. Miebo has been the first FDA approved drug for patients with DED associated with MGD and its ability to reduce the tear film layer evaporation rate and the minimal impact on the quality of vision are important innovations. Great expectations also accompany the phase 3 study of AZR-MD-001, understood to be a keratolytic and lipogenic agent able to improve meibum quantity and quality. The chance to specifically target MGD represents an important step forward and will allow more tailored treatment for each type of ocular surface disease.