May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Treatment of Allergic Conjunctivitis: An Evidence–based Update
Author Affiliations & Notes
  • H.A. D. Potter
    Ophthalmology & Visual Science, University of Wisconsin, Madison, WI
  • N.P. Barney
    Ophthalmology & Visual Science, University of Wisconsin, Madison, WI
  • Footnotes
    Commercial Relationships  H.A.D. Potter, None; N.P. Barney, Alcon C.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 4857. doi:
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      H.A. D. Potter, N.P. Barney; Treatment of Allergic Conjunctivitis: An Evidence–based Update . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4857.

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Abstract

Abstract: : Purpose: To assess the efficacy and effectiveness of Patanol (olopatadine hydrochloride 0.1%), Optivar (azelastine), and Zaditor (ketotifen fumarate 0.025%) in treating allergic conjunctivitis based on a systematic literature review and evidence rating. Allergic conjunctivitis affects a large percentage of the world’s population and is frequently treated using a variety of topical medications. Evidence–based evaluation of the effectiveness of these medications has not been performed. Methods: A MEDLINE search of the literature published in English from 1966 to present was performed using various combinations of relevant key words and drug names. The literature was limited to clinical trials of olopatadine hydrochloride 0.1%, azelastine, and ketotifen fumarate 0.025%. Studies were evaluated using similar criteria as defined by the American Academy of Ophthalmology glaucoma panel. The following categories were included: 1) studies evaluating the effectiveness of the drug in alleviating symptoms caused by environmental allergens encountered in the patients’ daily activities, and 2) trials evaluating the efficacy of the drugs in conjunctival antigen provocation or allergen challenges. Results: Sixteen randomized clinical trials in the evaluation of olopatadine, twelve to evaluate azelastine, and eight to evaluate ketotifen were identified. The studies ranged in sample size from 10 to 306. A total of 876 patients were treated with olopatadine, 683 with azelastine, and 310 with ketotifen, . A category I rating, (randomized, placebo controlled study of > 50 patients and opposite eye as control) was given four times to olopatadine (25%), two times to azelastine (17%), and three times to ketotifen (38%). Strong evidence for efficacy of a drug (p < 0.05 or > 25% difference in responder rate or examiner score) was found 13 times for Olopatadine (81%), 12 times for Azelastine (100%), and five times for Ketotifen (63%). Class A rating (>80% of studies demonstrating strong evidence) was given to olopatadine and azelastine. Conclusion:A stringent criterion for evaluation of published literature demonstrates that the three most commonly prescribed medications for the treatment of allergic eye disease have been moderately well studied. Preclinical studies likely offer the best evidence for the differences in these medications.

Keywords: conjunctivitis 
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