Efficacy of Interleukin-1 Inhibitor on Dry Eye Disease in Patients with Degenerative Arthritis

Purpose: To evaluate diacerein (interleukin-1 beta inhibitor) efficacy on ocular surface disease (OSD).Patients and Methods: This prospective observational study included patients who received diacerein for osteoarthritis and had dry eye (DE). The primary outcome was corneal staining score. Secondary outcomes were ocular surface disease index (OSDI) score, tear breakup time (TBUT), tear osmolarity (Osm), Schirmer's test results, interleukin-1 alpha (IL-1 alpha), interleukin-1 beta (IL-1 beta), and interleukin-1 receptor antagonist (IL-1Ra) levels in tears. All measurements were done at baseline and 2-month follow-up visits. Linear mixed models were used to examine the effect of all parameters, and log-transformed models were used for IL-1 alpha, IL-1 beta, and IL-1Ra analyses.Results: Thirty-four patients (31 females and 3 males) were enrolled. The corneal staining score improved by 1.29 points (P=0.022, 95% confidence interval [95% CI] 0.19 to 2.40) after 2 months, and the OSDI score improved by 17.2 points (P<0.001, 95% CI 10.82 to 23.58) but TUBT decreased by 0.66 seconds (P=0.021, 95% CI 0.10 to 1.22). No significant differences were observed in the tear Osm and Schirmer's test. IL-1Ra demonstrated no statistical difference, IL-1 alpha was significantly increased by 80% (P=0.260), and IL1 beta was significantly decreased by 99.21% (P<0.001).Conclusion: Diacerein can improve corneal staining and decrease IL-1 beta levels in tears, which reflects better DE symptoms. Diacerein may be a promising alternative treatment for patients with OSD and osteoarthritis.