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Topical loteprednol etabonate 0.5 % for treatment of vernal keratoconjunctivitis: efficacy and safety

  • Clinical Investigation
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Abstract

Purpose

To evaluate the efficacy and safety of loteprednol etabonate (LE) 0.5 % in vernal keratoconjunctivitis (VKC) patients compared to prednisolone and fluorometholone.

Methods

The patients were randomized into three groups: the loteprednol group, prednisolone group and fluorometholone group. Medications were administered four times daily, for a total of 28 days. Before starting treatment and at each visit thereafter, the major symptoms and signs of VKC were recorded and graded as 0 (none), 1 (mild), 2 (moderate) or 3 (severe). Adverse event reports including elevation of intraocular pressure (IOP) were recorded.

Results

There were no significant differences among the groups concerning baseline mean scores of signs and symptoms, which gradually improved in all except for pannus formation in the fluorometholone group. However, all signs and symptoms (except for chemosis) were significantly less improved in the eyes of the fluorometholone group compared with the other groups at each control visit. There was significant IOP elevation after the day 3 visit in the prednisolone group only.

Conclusion

LE was as effective as prednisolone and more effective than fluorometholone, and it had no side effects during the short-term treatment of VKC patients.

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References

  1. Ehlers WH, Donshik PC. Allergic ocular disorders: a spectrum of diseases. CLAO J. 1992;18:117–24.

    PubMed  CAS  Google Scholar 

  2. Abelson MB, George MA, Garofalo C. Differential diagnosis of ocular allergic disorders. Ann Allergy. 1993;70:95–109.

    PubMed  CAS  Google Scholar 

  3. Shoji J, Inada N, Sawa M. Antibody array-generated cytokine profiles of tears of patients with vernal keratoconjunctivitis or giant papillary conjunctivitis. Jpn J Ophthalmol. 2006;50:195–204.

    Article  PubMed  CAS  Google Scholar 

  4. Kosrirukvongs P, Visitsunthorn N, Vichyanond P, Bunnag C. Allergic conjunctivitis. Asian Pac J Allergy Immunol. 2001;19:237–44.

    PubMed  CAS  Google Scholar 

  5. Bonini S, Bonini S, Lambiase A, Marchi S, Pasqualetti P, Zuccaro O, et al. Vernal keratoconjunctivitis revisited: a case series of 195 patients with long-term followup. Ophthalmology. 2000;107:1157–63.

    Article  PubMed  CAS  Google Scholar 

  6. Leonardi A, Secchi AG. Vernal keratoconjunctivitis. Int Ophthalmol Clin. 2003;43:41–58.

    Article  PubMed  Google Scholar 

  7. Leonardi A. Vernal keratoconjunctivitis: pathogenesis and treatment. Prog Retin Eye Res. 2002;21:319–39.

    Article  PubMed  CAS  Google Scholar 

  8. Verin PH, Dicker ID, Mortemousque B. Nedocromil sodium eye drops are more effective than sodium cromoglycate eye drops for the long-term management of vernal keratoconjunctivitis. Clin Exp Allergy. 1999;29:529–36.

    Article  PubMed  CAS  Google Scholar 

  9. BenEzra D. Current practice: diagnosis and treatment in primary healthcare. Allergy. 1995;50:30–3.

    Article  PubMed  CAS  Google Scholar 

  10. Trocme SD, Raizman MB, Bartley GB. Medical therapy for ocular allergy. Mayo Clin Proc. 1995;67:6–9.

    Google Scholar 

  11. Jerndal T, Munkby M. Corticosteroid response in dominant congenital glaucoma. Acta Ophthalmol (Copenh). 1978;56:373–83.

    Article  CAS  Google Scholar 

  12. Pflugfelder SC, Maskin SL, Anderson B, Chodosh J, Holland EJ, De Paiva CS, et al. A randomized, double-masked, placebo-controlled, multicenter comparison of loteprednol etabonate ophthalmic suspension, 0.5%, and placebo for treatment of keratoconjunctivitis sicca in patients with delayed tear clearance. Am J Ophthalmol. 2004;138:444–57.

    Article  PubMed  CAS  Google Scholar 

  13. Dell SJ, Lowry GM, Northcutt JA, Howes J, Novack GD, Hart K. A randomized, double-masked, placebo-controlled parallel study of 0.2% loteprednol etabonate in patients with seasonal allergic conjunctivitis. J Allergy Clin Immunol. 1998;102:251–5.

    Article  PubMed  CAS  Google Scholar 

  14. Ilyas H, Slonim CB, Braswell GR, Favetta JR, Schulman M. Long-term safety of loteprednol etabonate 0.2% in the treatment of seasonal and perennial allergic conjunctivitis. Eye Contact Lens. 2004;30:10–3.

    Article  PubMed  Google Scholar 

  15. Stewart R, Horwitz B, Howes J, Novack GD, Hart K. Double-masked, placebo-controlled evaluation of loteprednol etabonate 0.5% for postoperative inflammation. Loteprednol Etabonate Post-operative Inflammation Study Group 1. J Cataract Refract Surg. 1998;24:1480–9.

    PubMed  CAS  Google Scholar 

  16. Friedlaender MH, Howes J. A double-masked, placebo-controlled evaluation of the efficacy and safety of loteprednol etabonate in the treatment of giant papillary conjunctivitis. Loteprednol Etabonate Giant Papillary Conjunctivitis Study Group I. Am J Ophthalmol. 1997;123:455–64.

    PubMed  CAS  Google Scholar 

  17. Loteprednol Etabonate US Uveitis Study Group. Controlled evaluation of loteprednol etabonate and prednisolone acetate in the treatment of acute anterior uveitis. Loteprednol Etabonate US Uveitis Study Group. Am J Ophthalmol. 1999;127:537–44.

    Article  Google Scholar 

  18. Kheirkhah A, Zavareh MK, Farzbod F, Mahbod M, Behrouz MJ. Topical 0.005% tacrolimus eye drop for refractory vernal keratoconjunctivitis. Eye (Lond). 2011;25:872–80.

    Article  CAS  Google Scholar 

  19. Uchio E, Itoh Y, Kadonosono K. Topical bromfenac sodium for long-term management of vernal keratoconjunctivitis. Ophthalmologica. 2007;221:153–8.

    Article  PubMed  CAS  Google Scholar 

  20. Bodor N, Buchwald P. Ophthalmic drug design based on the metabolic activity of the eye: soft drugs and chemical delivery systems. AAPS J. 2005;7:820–33.

    Article  Google Scholar 

  21. Howes J, Novack GD. Failure to detect systemic levels, and effects of loteprednol etabonate and its metabolite, pj-91, following chronic ocular administration. J Ocul Pharmacol Ther. 1998;14:153–8.

    Article  PubMed  CAS  Google Scholar 

  22. Wordinger RJ, Clark AF. Effects of glucocorticoids on the trabecular meshwork: towards a better understanding of glaucoma. Prog Retin Eye Res. 1999;18:629–67.

    Article  PubMed  CAS  Google Scholar 

  23. Bartlett JD, Horwitz B, Laibovitz R, Howes JF. Intraocular pressure response to loteprednol etabonate in known steroid responders. J Ocul Pharmacol. 1993;9:157–65.

    Article  PubMed  CAS  Google Scholar 

  24. Novack GD, Howes J, Crockett RS, Sherwood MB. Change in intraocular pressure during long-term use of loteprednol etabonate. J Glaucoma. 1998;7:266–9.

    PubMed  CAS  Google Scholar 

  25. Holland EJ, Bartlett JD, Paterno MR, Usner DW, Comstock TL. Effects of loteprednol/tobramycin versus dexamethasone/tobramycin on intraocular pressure in healthy volunteers. Cornea. 2008;27:50–5.

    Article  PubMed  Google Scholar 

  26. White EM, Macy JI, Bateman KM, Comstock TL. Comparison of the safety and efficacy of loteprednol 0.5%/tobramycin 0.3% with dexamethasone 0.1%/tobramycin 0.3% in the treatment of blepharokeratoconjunctivitis. Curr Med Res Opin. 2008;24:287–96.

    Article  PubMed  CAS  Google Scholar 

  27. Bucala R, Gallati M, Manabe S, Cotlier E, Cerami A. Glucocorticoid-lens protein adducts in experimentally induced steroid cataracts. Exp Eye Res. 1985;40:853–63.

    Article  PubMed  CAS  Google Scholar 

  28. Druzgala P, Wu WM, Bodor N. Ocular absorption and distribution of loteprednol etabonate, a soft steroid, in rabbit eyes. Curr Eye Res. 1991;10:933–7.

    Article  PubMed  CAS  Google Scholar 

  29. Pavesio CE, Decory HH. Treatment of ocular inflammatory conditions with loteprednol etabonate. Br J Ophthalmol. 2008;92:455–9.

    Article  PubMed  CAS  Google Scholar 

  30. Bilgihan K, Gurelik G, Akata F, Hasanreisoglu B. Fluorometholone induced cataract after photorefractive keratectomy. Ophthalmologica. 1997;211:394–6.

    Article  PubMed  CAS  Google Scholar 

  31. Costagliola C, Cati-Giovannelli B, Priccirrillo A, Delfino M. Cataracts associated with long-term topical steroids. Br J Dermatol. 1989;120:472–3.

    Article  PubMed  CAS  Google Scholar 

  32. Keklikci U, Soker SI, Sakalar YB, Unlu K, Ozekinci S, Tunik S. Efficacy of topical cyclosporin A 0.05% in conjunctival impression cytology specimens and clinical findings of severe vernal keratoconjunctivitis in children. Jpn J Ophthalmol. 2008;52:357–62.

    Article  PubMed  CAS  Google Scholar 

  33. Lambiase A, Leonardi A, Sacchetti M, Deligianni V, Sposato S, Bonini S. Topical cyclosporine prevents seasonal recurrences of vernal keratoconjunctivitis in a randomized, double-masked, controlled 2-year study. J Allergy Clin Immunol. 2011;128:896–7.

    Article  PubMed  CAS  Google Scholar 

  34. Pucci N, Novembre E, Cianferoni A, Lombardi E, Bernardini R, Caputo R, et al. Effi cacy and safety of cyclosporine eyedrops in vernal keratoconjunctivitis. Ann Allergy Asthma Immunol. 2002;89:298–303.

    Article  PubMed  CAS  Google Scholar 

  35. Vichyanond P, Tantimongkolsuk C, Dumrongkigchaiporn P, Jirapongsananuruk O, Visitsunthorn N, Kosrirukvongs P. Vernal keratoconjunctivitis: result of a novel therapy with 0.1% topical ophthalmic FK-506 ointment. J Allergy Clin Immunol. 2004;113:355–8.

    Article  PubMed  Google Scholar 

  36. Sawada S, Suzuki G, Kawase Y, Takaku F. Novel immunosuppressive agent, FK506. In vitro effects on the cloned T cell activation. J Immunol. 1987;139:1797–803.

    PubMed  CAS  Google Scholar 

  37. Friedlaender MH. Ocular allergy. Curr Opin Allergy Clin Immunol. 2011;11:477–82.

    Article  PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Ophthalmology, Batman State Hospital, Batman, Turkey

    Veysi Öner, Fatih Mehmet Türkcü, Mehmet Taş, Mehmet Fuat Alakuş & Yalçın İşcan

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  1. Veysi Öner
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  2. Fatih Mehmet Türkcü
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  3. Mehmet Taş
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  4. Mehmet Fuat Alakuş
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  5. Yalçın İşcan
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Correspondence to Veysi Öner.

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Öner, V., Türkcü, F.M., Taş, M. et al. Topical loteprednol etabonate 0.5 % for treatment of vernal keratoconjunctivitis: efficacy and safety. Jpn J Ophthalmol 56, 312–318 (2012). https://doi.org/10.1007/s10384-012-0152-5

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  • DOI: https://doi.org/10.1007/s10384-012-0152-5

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