Dataset Information

Efficacy of Proactive Topical Antihistamine Use in Patients with Seasonal Allergic Conjunctivitis.

ABSTRACT:

Introduction

Topical antihistamines are often instilled symptomatically to control patients' eye allergy symptoms. The purpose of this study was to evaluate the effectiveness of proactive and as-needed use of antihistamine eye drops in controlling symptoms and to examine whether proactive use may improve quality of life (QOL).

Methods

This was a prospective, multicenter, cohort study in Japan. We classified 418 patients who had developed certain symptoms and used antihistamine eye drops for 2 weeks into two groups: those who used the drops at the required frequency at a fixed time (proactive use) and those who used them as-needed. The Japanese Allergic and Conjunctival Diseases Quality of Life Questionnaire (JACQLQ) and Ten-Item Personality Inventory were used to evaluate QOL and personality. Participants' QOL was evaluated using JACQLQ scores after matching of baseline characteristics using propensity score analysis.

Results

After propensity score matching, 115 "proactive" and 115 "as-needed" patients were analyzed. After treatment, in "as-needed" patients, the overall QOL scale was 1.66 (95% CI 1.55-1.78); in "proactive" patients, the overall QOL scale was 1.34 (95% CI 1.23-1.46) and was significantly improved compared with the "as-needed" patients (analysis of covariance, P = 0.002). Furthermore, proactive use significantly alleviated depression (P = 0.03). This improvement of QOL was independent of improvement of the clinical sign scores.

Conclusion

Proactive use of topical antihistamine may serve as an effective means for improving QOL of patients with seasonal allergic conjunctivitis.

Trial registration

University Hospital Medical Information Network (UMIN) 000039554.

SUBMITTER: Fukushima A

PROVIDER: S-EPMC9618478 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Efficacy of Proactive Topical Antihistamine Use in Patients with Seasonal Allergic Conjunctivitis.

Fukushima Atsuki A Miyazaki Dai D Kishimoto Hirotsugu H Ebihara Nobuyuki N

Advances in therapy 20221016 12

<h4>Introduction</h4>Topical antihistamines are often instilled symptomatically to control patients' eye allergy symptoms. The purpose of this study was to evaluate the effectiveness of proactive and as-needed use of antihistamine eye drops in controlling symptoms and to examine whether proactive use may improve quality of life (QOL).<h4>Methods</h4>This was a prospective, multicenter, cohort study in Japan. We classified 418 patients who had developed certain symptoms and used antihistamine eye ...[more]

PMID: 36244054

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Project description:PurposeTo compare clinical outcomes and patient preference for the dexamethasone intracanalicular insert (DEX) versus topical loteprednol (LOT) or olopatadine (OLO) for the treatment of allergic conjunctivitis in a real-world model of allergen exposure.MethodsThis was a prospective comparative trial. Adults with testing-confirmed bilateral allergic conjunctivitis received DEX in the more symptomatic eye and either LOT 2 times daily or OLO once daily for 30 days in the fellow eye. The primary outcome was patient preference for treatment. Clinical outcomes included ocular itching and hyperemia, lid swelling, and watering/tearing. Safety outcomes included intraocular pressure (IOP).ResultsThirty patients participated and completed the study. All received DEX in the eye with worse symptoms and 15 received LOT and the other 15 received OLO in the other eye. Patients preferred DEX (10/15; 66.7%) over LOT (4/15; 26.7%), with one patient having no preference (p = 0.0103). Patients had no preference between DEX (8/15; 53.3%) and OLO (6/15; 40%), with one patient having no preference (p = 0.1044). In the DEX/LOT cohort, ocular itching and hyperemia improved more with DEX than LOT (p ≤ 0.009), while in the DEX/OLO cohort, the DEX eyes showed greater improvement in conjunctival hyperemia (p < 0.0001) but not itching (p = 0.074). No between-group differences were seen in eyelid swelling or tearing/watering in either cohort. Mean change in IOP was similar between the DEX and LOT eyes (p = 0.4921), and mean IOP rose more in the DEX eyes than the OLO eyes (by <1 mmHg; p = 0.0403).ConclusionOverall, this real-world study demonstrated that the dexamethasone intracanalicular insert was as effective as a topical antihistamine/mast cell stabilizer and more effective than topical steroids in relieving the signs and symptoms of allergic conjunctivitis. This insert should be considered as an alternative to topical therapy for the treatment of allergic conjunctivitis.

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Project description:PurposeThis study aimed to compare subjective allergic conjunctivitis symptoms and anti-allergic eye drop use patterns between antihistamine-releasing contact lens users and daily disposable soft contact lens users during Japan's hay fever season.MethodsThis web-based retrospective cohort study included daily disposable soft contact lens or antihistamine-releasing contact lens users with a history of seasonal allergic conjunctivitis who regularly used daily disposable soft contact lenses since the previous year. The total ocular symptom score (range 0-20) based on 5-item questionnaire scores and time from the start of the hay fever season to the initiation of anti-allergic eye drop treatment were compared between antihistamine-releasing contact lens users and daily disposable soft contact lens users.ResultsThe study included 24 participants: 17 using daily disposable soft contact lenses and 7 using antihistamine-releasing contact lenses. Antihistamine-releasing contact lens users experienced a greater reduction in total ocular symptom score from 2021 to 2022 compared with daily disposable soft contact lens users (mean total ocular symptom score [standard deviation]: daily disposable soft contact lens: -0.65 [1.4], antihistamine-releasing contact lens: -4.7 [3.6]; n = 24; Mann-Whitney U test, P = 0.010). Fourteen daily disposable soft contact lens users and five antihistamine-releasing contact lens users eventually required anti-allergic eye drops. Kaplan-Meier analysis revealed a significant delay in the initiation of anti-allergic eye drop treatment among those using antihistamine-releasing contact lenses compared with those using daily disposable soft contact lenses (median days, daily disposable soft contact lenses: 19 days, antihistamine-releasing contact lens: 57 days; n = 24; log-rank test, P = 0.045).ConclusionsAntihistamine-releasing contact lenses can potentially mitigate worsening ocular allergic responses during the hay fever season when used appropriately as a preventive measure.

Project description:PurposeTwo individual phase 3 conjunctival allergen challenge (CAC) studies of similar design have assessed the efficacy and safety of olopatadine hydrochloride (HCl) 0.77% for the treatment of allergic conjunctivitis. The purpose of this study is to evaluate the integrated efficacy and safety of olopatadine HCl 0.77% from a larger dataset by pooling data from the two individual CAC studies.MethodsData were pooled from two phase 3, randomized, multicenter, double-masked, active- and vehicle-controlled CAC studies. The primary comparison was on ocular itching scores between olopatadine HCl 0.77% versus vehicle (at onset and 24 hours) and olopatadine HCl 0.77% versus olopatadine 0.2% (at 24 hours). Additional end points included conjunctival redness, total redness, and proportion of itching responders at onset and 24-hour duration of CAC. For both primary and secondary analysis, mixed model repeated measures analysis was used, except for proportion of ocular itching responders. Sensitivity analyses were carried out using a two-sample t-test.ResultsThis analysis included 448 patients. Olopatadine HCl 0.77% was superior to vehicle (P<0.0001) at onset and 24-hour duration of action (difference in means: -1.14 to -1.52) and to olopatadine 0.2% (P=0.0009) at 24-hour duration of action in relieving ocular itch. Additionally, olopatadine HCl 0.77% substantially reduced conjunctival redness and total redness over vehicle and olopatadine 0.2% at onset and 24-hour duration of action. At 24 hours CAC, there were a higher proportion of itching responders with olopatadine HCl 0.77% compared to vehicle or olopatadine 0.2% (difference in proportion of responders: 43.17%, P<0.0001, and 17.25%, P=0.0012, respectively). No safety concerns were identified.ConclusionThis analysis confirms the findings from the individual studies. The rapid onset and prolonged duration of action (for 24 hours) of olopatadine HCl 0.77% supports once-daily dosing in the treatment of allergic conjunctivitis.

Dataset Information

Efficacy of Proactive Topical Antihistamine Use in Patients with Seasonal Allergic Conjunctivitis.

Introduction

Methods

Results

Conclusion

Trial registration

Publications

Efficacy of Proactive Topical Antihistamine Use in Patients with Seasonal Allergic Conjunctivitis.

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