Skip to main content
Log in

Efficacy and Safety of Ketotifen Eye Drops as Adjunctive Therapy to Mometasone Nasal Spray in Subjects with Seasonal Allergic Rhinoconjunctivitis

  • Original Research Article
  • Published:
Clinical Drug Investigation Aims and scope Submit manuscript

Abstract

Objective

To compare the efficacy and safety of ketotifen 0.025% ophthalmic solution (one drop/eye) with placebo as adjunctive therapy to mometasone nasal spray (50 μg/spray, two puffs/nostril) in subjects with seasonal allergic rhinoconjunctivitis (SARC).

Study design

Single-centre, randomised, double-masked, two-treatment, two-period crossover study.

Setting

8-hour allergen challenge in the Vienna Challenge Chamber.

Study participants

Subjects were ≥18 years old, had a ≥2-year history of SARC, and were sufficiently responsive to allergen challenge.

Interventions

During each challenge, subjects received a single dose of mometasone + ketotifen or mometasone + placebo.

Main outcome measures and results

47 subjects were randomised, and 44 completed both treatment sequences. Efficacy was based on mean area under the curve (AUC) values for symptom relief scores over time, with the primary variable being the AUC 4–6 hours postdose (AUC4–6) for relief of ocular itching. Between-treatment differences were assessed using analysis of variance. While improvement in ocular itching (AUC4–6) was observed with both treatments, improvement was significantly (p = 0.014) better with mometasone + ketotifen versus mometasone + placebo, as was improvement based on AUC0–6 (p = 0.009) and AUC0–2 (p = 0.006). Similar trends (in favour of mometasone + ketotifen) were observed for improvements in ocular redness, running nose, sneezing and ocular/nasal composite scores (p ≤ 0.05). None of the safety findings (slit-lamp biomicroscopy, vital signs, adverse events) were clinically significant. One subject discontinued treatment due to mild pharyngitis.

Conclusion

Ketotifen eye drops adjunctive to mometasone nasal spray provided greater relief of both ocular and nasal signs and symptoms than mometasone alone in subjects with SARC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Table I
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Notes

  1. 1The use of tradenames is for product identification purposes only and does not imply endorsement.

References

  1. Burkholter D, Schiffer P. The epidemiology of atopic diseases in Europe: a review. Allergy Clin Immunol News 1995; 7: 113–25

    Google Scholar 

  2. Bachert C, Vovolis V, Margari P, et al. Mizolastine in the treatment of seasonal allergic rhinoconjunctivitis: a European clinical experience with 5408 patients managed in daily practice (PANEOS SAR Study). Allergy 2001 Jul; 56(7): 653–9

    Article  PubMed  CAS  Google Scholar 

  3. Abelson MB, Schaefer K. Conjunctivitis of allergic origin: immunologic mechanisms and current approaches to therapy. Surv Ophthalmol 1993 Jul–Aug; 38 Suppl. : 115–32

    Article  PubMed  Google Scholar 

  4. Solomon A, Pe’er J, Levi-Schaffer F. Advances in ocular allergy: basic mechanisms, clinical patterns and new therapies. Curr Opin Allergy Clin Immunol 2001 Oct; 1(5): 477–82

    PubMed  CAS  Google Scholar 

  5. Bielory L. Ocular allergy guidelines: a practical treatment algorithm. Drugs 2002; 62(11): 1611–34

    Article  PubMed  CAS  Google Scholar 

  6. Leonardi A. The central role of conjunctival mast cells in the pathogenesis of ocular allergy. Curr Allergy Asthma Rep 2002 Jul; 2(4): 325–31

    Article  PubMed  Google Scholar 

  7. Abelson MB, Kaplan A. Ocular allergies often part of a broader clinical spectrum. Ophthalmol Times 2002 May 1; 27(9): 48–9

    Google Scholar 

  8. Bousquet J, Bullinger M, Fayol C, et al. Assessment of quality of life in patients with perennial allergic rhinitis with the French version of the SF-36 Health Status Questionnaire. J Allergy Clin Immunol 1994 Aug; 94 (2 Pt 1): 182–8

    Article  PubMed  CAS  Google Scholar 

  9. Blaiss MS. Quality of life in allergic rhinitis. Ann Allergy Asthma Immunol 1999 Nov; 83(5): 449–54

    Article  PubMed  CAS  Google Scholar 

  10. Meltzer EO. Quality of life in adults and children with allergic rhinitis. J Allergy Clin Immunol 2001 Jul; 108(1 Suppl. ): S45–53

    Article  PubMed  CAS  Google Scholar 

  11. Van Wijk R Gerth. Treatment of allergic rhinoconjunctivitis: a review of the role of topical levocabastine. Mediators Inflamm 1995; 4: S31–8

    Article  PubMed  CAS  Google Scholar 

  12. Howarth P. Antihistamines in rhinoconjunctivitis. Clin Allergy Immunol 2002; 17: 179–220

    PubMed  CAS  Google Scholar 

  13. Grant SM, Goa KL, Fitton A, et al. Ketotifen: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in asthma and allergic disorders. Drugs 1990 Sep; 40(3): 412–48

    Article  PubMed  CAS  Google Scholar 

  14. Abelson MB, Shams N, Kapik B, et al. Ocular tolerance and safety of ketotifen fumarate 0.025% ophthalmic solution compared with placebo [abstract]. Clin Experiment Ophthalmol 2002 Apr 21; 30S: A323

    Google Scholar 

  15. Guttman C, Abelson MB. Ketotifen active against seasonal allergic conjunctivitis. Ophthalmol Times 2000 Jun 1; 25(11): 30

    Google Scholar 

  16. Onrust SV, Lamb HM. Mometasone furoate: a review of its intranasal use in allergic rhinitis. Drugs 1998 Oct; 56(4): 725–45

    Article  PubMed  CAS  Google Scholar 

  17. Kyrein HJ, Horak F, Nirnberger G, et al. Efficacy of intranasally applied dimethindene maleate solution as spray in adult volunteers with symptoms of seasonal allergic rhinitis in the Vienna Challenge Cchamber. Arzneimittel Forschung 1996 Aug; 46(8): 794–9

    PubMed  CAS  Google Scholar 

  18. Horak F, Jager S, Toth J, et al. Efficacy and tolerability of astemizole-D and Loratadine-D during prolonged, controlled allergen challenge in the Vienna Challenge Chamber. Arzneimittel Forschung 1996 Nov; 46(11): 1077–81

    PubMed  CAS  Google Scholar 

  19. Horak F, Berger UE, Menapace R, et al. Dose-dependent protection by azelastine eye drops against pollen-induced allergic conjunctivitis: a double-blind, placebo-controlled study. Arzneimittel Forschung 1998 Apr; 48(4): 379–84

    PubMed  CAS  Google Scholar 

  20. Horak F, Unkauf M, Beckers C, et al. Efficacy and tolerability of intranasally applied dimetindene maleate solution versus placebo in the treatment of seasonal allergic rhinitis. Arzneimittel Forschung 2000 Dec; 50(12): 1099–105

    PubMed  CAS  Google Scholar 

  21. Horak F, Stubner P, Zieglmayer R, et al. Controlled comparison of the efficacy and safety of cetirizine 10mg o.d. and fexofenadine 120mg o.d. in reducing symptoms of seasonal allergic rhinitis. Int Arch Allergy Immunol 2001 May; 125(1): 73–9

    Article  PubMed  CAS  Google Scholar 

  22. Stubner UP, Toth J, Marks B, et al. Efficacy and safety of an oral formulation of cetirizine and prolonged-release pseudoephedrine versus xylometazoline nasal spray in nasal congestion. Arzneimittel Forschung 2001 Nov; 51(11): 904–10

    PubMed  CAS  Google Scholar 

  23. Guttman C, Marioneaux SJ, Udell IJ. An agent able to antagonize histamine, stabilize mast cells [ketotifen fumarate]. Ophthalmol Times 2001 May 15; 26(10): 22–3

    Google Scholar 

  24. Brunzini M, Lambrou G, Udell I, et al. Ketotifen fumarate (Zaditor) eye drops: a new treatment option for allergic conjunctivitis. Ophthalmic Pract 2001; 19(2): 78–80

    Google Scholar 

  25. Abelson MB, Chapin MJ, Kapik BM, et al. Ocular tolerability and safety of ketotifen fumarate ophthalmic solution. Adv Ther 2002 Jul–Aug; 19(4): 161–9

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This publication was sponsored in part by Novartis Ophthalmics, the manufacturer of ketotifen 0.025% ophthalmic solution. The investigator received compensation for conducting the study but has no proprietary or stock interest in Novartis Ophthalmics.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to F. Horak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Horak, F., Stuebner, P., Zieglmayer, R. et al. Efficacy and Safety of Ketotifen Eye Drops as Adjunctive Therapy to Mometasone Nasal Spray in Subjects with Seasonal Allergic Rhinoconjunctivitis. Clin. Drug Investig. 23, 597–604 (2003). https://doi.org/10.2165/00044011-200323090-00006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00044011-200323090-00006

Keywords

Navigation