July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
The efficacy of 0.1% Tacrolimus Ophthalmic Suspension in the Treatment of Atopic Keratoconjunctivitis: A one year follow-up study
Author Affiliations & Notes
  • HIROYUKI YAZU
    Ophthalmology, Keio University School of Medicine, Tokyo, Japan
    Ophthalmology, Hino Municipal Hospital, Tokyo, Japan
  • Eisuke Shimizu
    Ophthalmology, Keio University School of Medicine, Tokyo, Japan
  • Naohiko Nakayama
    Ophthalmology, Keio University School of Medicine, Tokyo, Japan
  • Murat Dogru
    Ophthalmology, Keio University School of Medicine, Tokyo, Japan
  • Naoko Okada
    Ophthalmology, Tsurumi University Dental Hospital, Kanagawa, Japan
  • Kazumi Fukagawa
    Ophthalmology, Keio University School of Medicine, Tokyo, Japan
    Ryogoku Eye Clinic, Tokyo, Japan
  • Hiroshi Fujishima
    Ophthalmology, Tsurumi University Dental Hospital, Kanagawa, Japan
  • Footnotes
    Commercial Relationships   HIROYUKI YAZU, None; Eisuke Shimizu, None; Naohiko Nakayama, None; Murat Dogru, Kobayashi Pharmaceutical Co., Ltd (F), Otsuka Pharmaceutical Co., Ltd. (F), Santen, Pharmaceutical Co., Ltd (F); Naoko Okada, None; Kazumi Fukagawa, Santen, Pharmaceutical Co., Ltd (F); Hiroshi Fujishima, Alcon Laboratories, Inc. (F), Allergan, Inc. (F), Kobayashi Pharmaceutical Co., Ltd (F), Otsuka Pharmaceutical Co., Ltd (F), Santen, Pharmaceutical Co., Ltd (F), Senju Pharmaceutical Co., Ltd (F), White Medical Co., Ltd (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5566. doi:
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      HIROYUKI YAZU, Eisuke Shimizu, Naohiko Nakayama, Murat Dogru, Naoko Okada, Kazumi Fukagawa, Hiroshi Fujishima; The efficacy of 0.1% Tacrolimus Ophthalmic Suspension in the Treatment of Atopic Keratoconjunctivitis: A one year follow-up study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5566.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To examine the efficacy of 0.1% tacrolimus ophthalmic suspension in treating severe atopic keratoconjunctivitis (AKC) in a one year follow-up.

Methods : This was a single center retrospective clinical study. Sixty eyes from 30 patients with severe AKC who were treated with 0.1% tacrolimus ophthalmic suspension q.i.d were included. The mean age of the patients was 21.53 ± 13.63 years (range, 9 - 52 years). Severity of objective signs was observed at baseline (before treatment) and 2 weeks, 1, 2, 3, 6, and 12 months after treatment initiation. Ten objective signs for the palpebral conjunctiva (hyperemia, swelling, follicles, papillae, and giant papillae), bulbar conjunctiva (hyperemia and chemosis), limbus (Trantas’ dot and swelling), and corneal epithelial disorder were assessed using 4 grades (0 = Normal; 1+ = Mild; 2+ = Moderate; 3+ = Severe). Efficacy endpoint was assessed based on the extent of change in the total score of objective signs at the end of treatment. Safety was assessed based on the severity and the incidence of adverse events.

Results : The total score of the 10 clinical signs (range 0 – 30) significantly decreased from baseline 2 weeks after beginning tacrolimus eye drop treatment (p = 0.004). The mean total score of clinical signs was 14.9 ± 7.2 at the start of treatment and decreased to 6.8 ± 4.5 at 12 months after initiation (mean change from baseline = −5.6 ± 5.7). Treatment was gradually tapered, with increasing intervals between applications. Additional medications, such as topical anti-allergic agents or/and corticosteroids, were required to provide relief in eighteen patients during follow-up. All patients complained of a mild burning sensation upon application, which was well-tolerated. No patient discontinued treatment because of adverse drug effects. Herpes keratitis was observed in 3 cases during follow-up, however, these could be controlled completely with medical treatment.

Conclusions : The results of this one year follow-up study suggest that 0.1% tacrolimus ophthalmic suspension is effective in the treatment of severe AKC cases refractory to standard conventional steroid treatment.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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