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A.J. Flach, L.D. Waterbury; Comparison of Ketorolac, Diclofenac and Loteprednol Etabonate in a Rabbit Model of Ocular Inflammation . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3937.
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Purpose: To compare the anti–inflammatory activity of ketorolac tromethamine 0.4% (Acular LSTM, Allergan Inc, Irvine, CA; ketorolac 0.4%), ketorolac tromethamine 0.1%, diclofenac sodium 0.1% (Voltaren®, Novartis Pharmaceuticals Corp, East Hanover, NJ; diclofenac 0.1%), and loteprednol etabonate 0.5% suspension (LotemaxTM, Pharmos Corp, Iselin, NJ; loteprednol 0.5%) in a rabbit model of ocular inflammation. Methods: In this randomized study, one of the following NSAID/steroid solutions was administered to New Zealand white rabbits: ketorolac 0.4% or 0.1%, diclofenac 0.1%, or loteprednol 0.5%. Drug (or vehicle) was administered in 2 single doses (50 µL/dose): the first dose 2 hours before lipopolysaccharide (LPS) endotoxin challenge and second dose 1 hour before LPS challenge, with drug administered to one eye and vehicle administered to the contralateral eye. Vehicle contained phosphate buffered saline. One additional group of rabbits received vehicle without LPS endotoxin. An ocular inflammatory response was induced 1 hour after the last 50–µL dose by the intravenous administration of LPS. All rabbits received FITC–dextran to monitor the breakdown of the blood–aqueous barrier by fluorophotometry. A t–test assuming unequal variance was used for between–group comparisons. Results: Ketorolac 0.4% resulted in a nearly complete inhibition of FITC–dextran in the anterior chamber compared to vehicle control as measured by fluorophotometry of the rabbit eye (P < .001). The inhibition observed by ketorolac 0.4% by fluorophotometry was nearly identical to that observed with ketorolac 0.5% in a recent published study (JOPT, 2004;20:345). Diclofenac 0.1% was significantly less active in inhibiting the inflammatory response as measured by the percent inhibition when compared to vehicle (P < .01) or to ketorolac 0.1% (P < .01). Loteprednol 0.5% did not significantly block the inflammatory response in this model (P = .165). Conclusions: Ketorolac at all concentrations tested is more potent than diclofenac and loteprednol. These findings are consistent with those described previously in a systemic study (JPET, 1999;288:1288.)
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