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Y. Satake, Y. Takano, M. Dogru, A. Igarashi, N. Okada, M. Tanaka, K. Fukagawa, J. Shimazaki, H. Fujishima; The Efficacy of Topical Tacrolimus Hydrate in Patients With AKC/VKC. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6319.
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© ARVO (1962-2015); The Authors (2016-present)
The efficacy of tacrolimus hydrate eye drops ( TALYMUS® OPHTHALMIC SUSPENSION 0.1%, Senju Pharmaceutical Co., Osaka, Japan, released to the market in 2008) for the treatment of severe allergic disorders, such as atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC) has been reported. However, there have been no reports concerning the ideal protocol for tapering such medication after remission. In this study, we studied the clinical course of patients after cessation of treatment with tacrolimus eye drops.
Eighteen eyes from nine patients with AKC/VKC (3/6 patients respectively; 6 male, 3 female patients, mean age 24), who discontinued use of tacrolimus ophthalmic suspension at the end of the pre-release clinical trial, were enrolled in the study. All eyes exhibited giant papillae formation on the upper tarsal conjunctiva at the beginning of clinical trial. Serum IgE levels for perennial antigens, such as mite and house dust were strongly positive in all patients. Clinical course (redness, edema, follicle, and papillary formation of tarsal conjunctiva, Trantas dot and limbal edema, and corneal epithelium) were assessed retrospectively after cessation of tacrolimus treatment.
The mean frequency of instillation of tacrolimus eye drops was 1.3 times per day at cessation of treatment and clinical findings in all cases were inactive with no giant papillary formation. After cessation, anti-allergic eye drops or steroid eye drops were prescribed as necessary. Three out of the 9 cases were stable after cessation but the other 6 cases experienced recurrence of allergic inflammation. The mean time to recurrence was 4.8 weeks (range 1~12 weeks) and all criteria except Trantas dot and limbal edema worsened in these 6 cases. Five of the 6 cases resumed use of tacrolimus after its official release into the market.
Tacrolimus eye drops are not only effective for severe allergic inflammation but may also be effective in the prevention of recurrence of symptoms after control of acute inflammation.
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