Topical bromfenac for post-cataract extraction: A systematic review and pooled analysis

Abstract

Bromfenac, a promising ophthalmic non-steroidal anti-inflammatory drug, has been used once daily for postoperative ocular inflammation and pain with satisfying efficacy, however, no integrated conclusion on its safety in clinical settings has been drawn. The purpose of this pooled analysis is to investigate the safety and efficacy of once daily bromfenac for ocular inflammation and pain among patients after cataract extraction (CE). MEDLINE, PsycINFO, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to September 2014. Randomized controlled trials (RCTs) that studied topical bromfenac after CE were analyzed. Included studies were systemically reviewed, and effects were summarized using odds ratio (OR) with suitable effect model. Four RCTs involving 2294 participants were included. Topical bromfenac significantly increased the proportion of cleared ocular inflammation (OR, 2.37; 95% confidence interval [CI], 1.83-3.07; P <0.00001), ocular pain free (OR, 5.14; 95% CI, 4.07-6.49; P <0.00001), and decreased risk of overall adverse events (OR, 0.47; 95% CI, 0.38-0.58; P <0.00001). Bromfenac has been shown to be a safe and effective treatment for postoperative pain and inflammation in subjects undergoing CE. This is evidenced by the lower incidence of adverse events and the low scores for ocular pain and inflammation across multiple RCTs. However, demographics, co-morbidities of study participants, and the amount of co-medication were not reported, these possible sources of heterogeneity should be examined in future clinical trials.

Comparative evaluation of once-daily and twice-daily dosing of topical bromfenac 0.09%: aqueous pharmacokinetics and clinical efficacy study

“…Topical bromfenac is as efficacious as topical corticosteroids in controlling postoperative inflammation with a fast onset of anti-inflammatory action, enhanced ocular penetration, favorable safety profile and minimal corneal epithelial cell damage. [18][19][20] Various commercial preparations of bromfenac are available with drug concentrations ranging from 0.075% to 0.1% and dosing regimens requiring once or twice daily instillation. 7 Aqueous pharmacokinetics of topical bromfenac has been studied mainly in experimental animal studies, with only a few studies evaluating the pharmacokinetics in aqueous humor of humans.…”