INTRODUCTION: Dry eye disease (DED) is a multifactorial symptomatic disease characterized by a loss of tear film and/or ocular surface homeostasis. Lifitegrast ophthalmic solution 5% is a lymphocyte function-associated antigen-1 antagonist used to treat the signs and symptoms of DED.

AREAS COVERED: This article examines the lifitegrast mechanism of action, pharmacology and formulation, efficacy, safety, and real-world evidence for treatment of DED, based on a comprehensive review of the literature.

EXPERT OPINION: Inflammation is a well-recognized contributor to DED pathogenesis. Persistent challenges to the ocular surface over time can trigger or perpetuate inflammatory responses that further exacerbate the clinical signs and symptoms of DED. Lifitegrast has demonstrated efficacy in reducing both signs and symptoms of DED in controlled clinical trials and in real-world clinical settings. The mechanism that directly inhibits inflammatory processes allows for a rapid response, with improvements in ~2 weeks for some symptom outcomes. Given the heterogeneity of DED and the diversity of initiating factors, optimizing disease management may require targeting multiple, patient-specific pathogenic mechanisms of DED. Educating general practitioners and patients about the disease state, the role of inflammation, and availability of anti-inflammatory treatments such as lifitegrast may further improve DED outcomes and overall quality of life.