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Pia Allegri, Giuseppina Marrazzo, Chiara Ciurlo, Antonio Mastromarino, Silvia Autuori, Ugo Murialdo; Retrospective study to evaluate the efficacy on vernal kerato-conjunctivitis (VKC) of 2% Ectoine versus 0.05% ketotifen eye-drops. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2492.
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Ectoine is a strong water structure-forming solute. It exerts cell-protective, anti-inflammatory and anti-allergic activity. VKC is a rare, severe, challenging seasonal eye-allergic childhood disease managed in our referral hospital center. We underwent a retrospective case series review to evaluate and compare, when administered in pre-allergic and allergic period, the efficacy of this solution versus 0.05% Ketotifen eye drops (Ketoftil®) on signs and symptoms of VKC
We evaluated records from 64 male pediatric subjects (mean age 8.5 y ± 2 months) and divided it into two groups of patients treated three times a-day with Ectoine 2% (Group A) and patients treated with 0.05% Ketotifen eye drops (Group B). The included patients were evaluated from February 2013 until November 2013 on three visits (at the beginning of treatment, 3 (±10 days) months later and 6 (±20 days) months).Main criteria of statistical evaluation were for VKC slit-lamp signs: Focal or diffuse conjunctival hyperemia; BUT; Modified Oxford scale; VKC grading (modified Bonini scale); and for VKC signs: VAS scale grading ( ocular pain, itching, tearing, photophobia and foreign body sensation); Quick questionnaire on tolerance of the formulation. We compared the previous year treatment and evaluated the beginning of Cyclosporine eye drops treatment compared to the previous season and the different Cyclosporine dosages (0.25%-0.5%-1%-2%) used before
When evaluating symptoms and signs of VKC patients, both groups showed a significant improvement (p<0.0001) from baseline and at three and six months after treatment. Althought we found a significant difference (p<0.0001) between the two treatments on the tolerability at each time point. Furthermore both drugs delayed the beginning of treatment with Cyclosporine eye drops and reduced the concentration dosage.
Our case series review allowed us to establish that both topic treatments with 2% Ectoine as well as 0.05% Ketotifen are effective in improving signs and symptoms of VKC and to delay the adjuvant treatment with Cyclosporin. Therefore, we can conclude that Ectoine (a natural compound without any side effects) can be considered, in efficacy, equal to Ketotifen and is better tolerated by pediatric patients. Further studies with the inclusion of a bigger number of subjects are required.
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