Treatment response to cenegermin varies by disease stage in neurotrophic keratopathy

Cenegermin is an effective treatment for neurotrophic keratopathy (NK) across disease stages, but recurrence is fairly common, according to a study.

This retrospective case series from a single clinical center evaluated 52 eyes from 49 patients. Patients were followed for a mean of 26 months.

At baseline, most eyes had moderate or severe disease, with nearly half classified as Mackie stage 2 and another 15% as stage 3.

After 8 weeks of treatment, 67.3% of patients showed improvement. Among those with stage 2 or 3 NK, 62.5% experienced complete resolution of their corneal epithelial defect, while patients with stage 1 disease demonstrated a significant reduction in corneal staining scores. Statistical analysis showed that Mackie staging strongly predicted treatment success.

Despite these gains, NK recurred in 37.5% of eyes within 4 months. For patients who underwent a second course of cenegermin, 58.3% again achieved a positive response.

The authors concluded that cenegermin is an effective therapeutic option in real-world practice, though clinicians should be aware of the relatively high risk of recurrence and the importance of baseline disease stage in forecasting outcomes.

Reference
Latifi G, Chea PD, Al-Hashimi S, et al. Outcome of Cenegermin in the Treatment of Neurotrophic Keratopathy. Cornea. 2025;doi: 10.1097/ICO.0000000000004024. Epub ahead of print. PMID: 41247282.