Antihistamines in Ocular Allergy: Are They All Created Equal?

Abelson, Mark B.; McLaughlin, James T.; Gomes, Paul J

doi:10.1007/s11882-011-0188-5

Cited by 26 publications

(23 citation statements)

References 63 publications

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“…The signs and symptoms of AC are primarily caused by the action of mast cell-derived histamine, which acts on H 1 and H 2 histamine receptors in the surrounding ocular tissues 6,7. For this reason, medications that stabilize mast cells and reduce degranulation and those that directly antagonize the action of histamine at its receptors have become the first-line therapy for AC 8,9. Medications of this class, dual-action antihistamines, have both an improved safety profile and increased therapeutic effect compared to older topical agents (eg, pheniramine maleate) used in the treatment of AC 3,5,8,9…”

Section: Introductionmentioning

confidence: 99%

Treatment of allergic conjunctivitis with bepotastine besilate ophthalmic solution 1.5%

Bergmann

Williams²,

Gomes

2014

OPTH

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PurposeTo examine the pooled per-protocol ocular end points from two conjunctival allergen challenge (CAC) clinical trials of the dual-action antihistamine bepotastine besilate ophthalmic solution (BBOS) 1.5%.MethodsTwo Phase III, placebo-controlled, double-masked, randomized clinical trials were conducted at a total of six separate centers using the CAC model of allergic conjunctivitis. The same study design was employed for both clinical trials, with subjects randomly assigned to either BBOS 1.5% (n=78) or placebo (n=79) treatment. Each subject received one eye drop of the test agent bilaterally at different study visits 15 minutes, 8 hours, or 16 hours prior to a CAC. Primary ocular end points included changes in ocular itching reported at 3, 5, and 7 minutes and conjunctival hyperemia assessed at 7, 15, and 20 minutes following each CAC. Secondary ocular end points included chemosis as well as episcleral and ciliary hyperemia judged by investigators, and tearing (scored as either absent or present) and eyelid swelling judged by subjects.ResultsA statistically significant reduction in ocular itching was observed for BBOS 1.5% treatment compared to placebo at all time points (P<0.0001), while measures for onset and 8-hour persistence of action also reached clinical significance (ie, ≥1.0 unit difference) at a majority of time points. In addition, a significant reduction in conjunctival hyperemia was achieved at a majority of time points during the onset of action CAC test. Secondary end points were also significantly improved compared to placebo, most prominently for reduced tearing at all study visits and reduced eyelid swelling at the onset of action and 8-hour study visits. Adverse events were generally mild and transient.ConclusionBBOS 1.5% rapidly reduced CAC-induced ocular itching with duration of effectiveness of at least 8 hours after dosing. Certain secondary signs of inflammation were also significantly reduced.

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Section: Introductionmentioning

confidence: 99%

Treatment of allergic conjunctivitis with bepotastine besilate ophthalmic solution 1.5%

Bergmann

Williams²,

Gomes

2014

OPTH

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“…Allergen binding to specific IgE molecules triggers mast cell degranulation and the subsequent increase in histamine leads to activation of both H 1 -type and H 2 -type histamine receptors 2–4. These stimulate itching and vasodilation, respectively, thereby initiating a response that may last minutes or hours.…”

Section: Introductionmentioning

confidence: 99%

“…Currently available antagonists of histamine receptor activation have significant benefit in relieving the signs and symptoms of allergic conjunctivitis, and are particularly effective in relieving ocular itching 4. Another advantage of these compounds is that many can be formulated for topical delivery, reducing the adverse effects associated with systemic formulations 6,7.…”

Section: Introductionmentioning

confidence: 99%

“…Both olopatadine 0.2% and alcaftadine 0.25% are classified as dual-action antiallergic medications, meaning they act both directly to inhibit histamine receptor activation and indirectly to reduce allergic responses by attenuating mast cell degranulation 4,7. Olopatadine was first used in a formulation strength of 0.1% and indicated for twice-daily use.…”

Section: Introductionmentioning

confidence: 99%

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A multicenter evaluation of the efficacy and duration of action of alcaftadine 0.25% and olopatadine 0.2% in the conjunctival allergen challenge model

Ackerman¹,

D'Ambrosio²,

Greiner³

et al. 2013

JAA

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BackgroundThe purpose of this study was to evaluate the efficacy and duration of action of once-daily dosing with alcaftadine 0.25% ophthalmic solution and olopatadine 0.2% ophthalmic solution as compared with placebo in the prevention of ocular itching, and to directly compare the efficacy of alcaftadine 0.25% with olopatadine 0.2% in the prevention of ocular itching associated with allergic conjunctivitis using the conjunctival allergen challenge model.MethodsSubjects with allergic conjunctivitis (n = 127) were enrolled in a multicenter, double-masked, randomized, active-controlled and placebo-controlled clinical trial. Using the conjunctival allergen challenge model, this study was conducted over the course of approximately 5 weeks. Subjects were randomized into one of three treatment arms: alcaftadine 0.25% ophthalmic solution, olopatadine 0.2% ophthalmic solution, or placebo. Study medications were administered twice over the course of the trial. The primary efficacy measure for the study was ocular itching evaluated by the subject at 3, 5, and 7 minutes post challenge. Secondary endpoints, measured at 7, 15, and 20 minutes post challenge, included conjunctival, ciliary, and episcleral redness, lid swelling, chemosis, and tearing. Duration of action was measured at 16 and 24 hours post-instillation of the study medication at visits 3 and 4, respectively.ResultsFor the primary measure of ocular itching, both actives, alcaftadine 0.25% and olopatadine 0.2%, were statistically superior to placebo at all three measured time points for both the 16-hour and 24-hour measures (P < 0.0001). Eyes treated with alcaftadine 0.25% had numerically lower mean ocular itching scores than eyes treated with olopatadine 0.2% at every time point, and this difference was statistically significant at the 3-minute time point 16 hours post instillation (P = 0.026). Eyes treated with alcaftadine 0.25% and with olopatadine 0.2% displayed significantly less lid swelling relative to placebo at every time point for the 16-hour and 24-hour post-instillation visits (P < 0.005). Alcaftadine 0.25% was the only active treatment that provided statistically significant relief of chemosis at every time point of the 24-hour post-instillation visit.ConclusionBoth the alcaftadine 0.25% and olopatadine 0.2% ophthalmic solutions provided highly effective relief of ocular itching at both 16 and 24 hours post-instillation. Treatment differences between the actives were most pronounced at the earliest time point (3 minutes post-challenge) following conjunctival allergen challenge (16 hours), when alcaftadine 0.25% ophthalmic solution was statistically superior to olopatadine 0.2% ophthalmic solution. Alcaftadine 0.25% was the only treatment to provide significant relief from chemosis at both 16 and 24 hours post-instillation. Both active treatments and placebo were generally safe and well tolerated.

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“…[9][10][11] A total of 80% of respondents stated that they are likely to write a prescription for antihistamine medications.…”

Section: Discussionmentioning

confidence: 99%

A survey of optometrists' ophthalmic medication prescribing

González¹,

Bennett²,

Lakhani³

2014

OPTO

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Abstract:Optometry is recognized as a primary care profession within the health care system. For years, much emphasis has been placed on the core function of optometrists as prescribers for refractive correction, yet little is known about their medication prescribing habits. Optometrists have had the ability to prescribe medications for the last 30 years, and still little information is available about optometric pharmaceutical trends. This study consists of a survey aimed at obtaining self-reported data to depict optometrists' likelihood of prescribing ophthalmic medications during a regular clinic day. We conclude that optometrists are indeed using medications in their clinics, and the trends are very similar to the epidemiological distribution of eye disorders in the general population.

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Antihistamines in Ocular Allergy: Are They All Created Equal?

Cited by 26 publications

References 63 publications

Treatment of allergic conjunctivitis with bepotastine besilate ophthalmic solution 1.5%

Treatment of allergic conjunctivitis with bepotastine besilate ophthalmic solution 1.5%

A multicenter evaluation of the efficacy and duration of action of alcaftadine 0.25% and olopatadine 0.2% in the conjunctival allergen challenge model

A survey of optometrists' ophthalmic medication prescribing

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Antihistamines in Ocular Allergy: Are They All Created Equal?

Cited by 26 publications

References 63 publications

Treatment of allergic conjunctivitis with bepotastine besilate ophthalmic solution 1.5%

Treatment of allergic conjunctivitis with bepotastine besilate ophthalmic solution 1.5%

A multicenter evaluation of the efficacy and duration of action of alcaftadine 0.25% and olopatadine 0.2% in the conjunctival allergen challenge model

A survey of optometrists&#39; ophthalmic medication prescribing

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Product

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A survey of optometrists' ophthalmic medication prescribing