Vuity From Allergan

The FDA has approved pilocarpine hydrochloride ophthalmic solution 1.25% (Vuity, Allergan, an AbbVie company) to treat presbyopia in adults.¹

Also known as age-related blurry near vision, presbyopia is a common and progressive condition that impairs the eye’s ability to focus on objects that are in close range. Prior to the onset of presbyopia, the clear lens behind the iris changes shape and focuses light onto the retina, allowing the eye to see objects that are nearby. In a presbyopic eye, the clear lens is less flexible and does not change shape as easily, which causes difficulty focusing on objects in close range. Presbyopia usually occurs after the age of 40 years and affects 128 million Americans, accounting for almost half the population of adults in the United States. The condition can be diagnosed by an ophthalmologist or optometrist.²

Pharmacology and Pharmacokinetics

Vuity is a cholinergic muscarinic receptor agonist. It exerts its effect through the activation of muscarinic receptors in smooth muscles, such as the ciliary and iris sphincter muscles. The contraction of the iris sphincter muscle results in constriction of the pupil, which improves intermediate and near visual acuity while maintaining some of the pupil’s response to light. Vuity also causes contraction of the ciliary muscle and may alter the eye to a more myopic state.

Investigators evaluated systemic exposure to Vuity in 22 participants with presbyopia who received 1 drop in each eye once daily for 30 days. The mean maximum concentration was 1.95 ng/mL. The median time to maximum concentration was 0.3 hours, with a range from 0.2 to 0.5 hours after administration.¹

Dosage and Administration

The recommended dose of Vuity is 1 drop in each eye once daily. When more than 1 topical ophthalmic product is being used, the medications should be administered at least 5 minutes apart.¹

Clinical Trials

Vuity was evaluated for efficacy in the treatment of presbyopia in 2 double-masked, randomized, vehicle-controlled studies of 30 days’ duration. Investigators randomized 750 participants aged 40 to 55 years with presbyopia to receive 1 drop of either Vuity or a placebo once daily in each eye. Both studies met their primary end points; a statistically significant proportion of participants receiving Vuity gained 3 lines, or the ability to read 3 additional lines on a reading chart, or more in mesopic (low light), high-contrast binocular distance corrected near visual acuity, without losing more than 1 line (5 letters) of corrected distance visual acuity at day 30, hour 3, compared with those receiving placebo.^1,2

Contraindications, Warnings, and Precautions

The use of Vuity is contraindicated in patients with a known hypersensitivity to the medication or any of its components.

Patients who are using Vuity should be cautious when driving at night and during hazardous activities when lighting is poor. Because temporary problems may occur when changing focus between distant and near objects, counsel patients not to drive or use machinezs of retinal detachment have been reported during the use of other miotic agents. These cases occurred when susceptible patients and those with preexisting retinal disease used the medication. Patients should seek immediate medical care if sudden vision loss occurs. Vuity should not be used if iritis is present. Patients who wear contact lenses should remove their lenses prior to administering Vuity and wait 10 minutes after instilling the drops before reinserting the lenses. To prevent contamination and injury to the eye, the medication bottle should not touch the eye or any other surface.

The most common adverse reactions are conjunctival hyperemia and headache.¹

Monica Holmberg, PharmD, BCPS, is a pharmacist and Pharmacy Times® contributor.

References

1. Vuity. Prescribing information. Allergan, an AbbVie Company; 2021. Accessed January 4, 2022. https://www.rxabbvie.com/pdf/ vuity_pi.pdf

2. Vuity (pilocarpine HCI ophthalmic solution) 1.25%, the first and only FDA-approved eye drop to treat age-related blurry near vision (presbyopia), is now available. News release. Allergan, an AbbVie company. December 9, 2021. Accessed January 4, 2022. https:// news.abbvie.com/news/press-releases/ vuity-pilocarpine-hci-ophthalmic-solution- 125-first-and-only-fda-approved-eye-drop- to-treat-age-related-blurry-near-vision- presbyopia-is-now-available.htm