Treating allergic conjunctivitis: A once-daily medication that provides 24-hour symptom relief

Abstract

Background: Allergic conjunctivitis (AC) is a common ocular inflammatory manifestation of allergen exposure in sensitized individuals. Signs and symptoms of AC can decrease quality of life, interfere with productivity, and lead to considerable economic burden. Consistent suppression of conjunctival inflammation is necessary for managing AC, but currently available medications require frequent administration and exhibit limited duration of action.

Methods: In this review, we summarized AC pathogenesis, diagnosis, and current treatment options as well as their limitations. Findings from the literature were discussed in the context of the unmet need for a once-daily medication with sustained 24-hour effectiveness.

Results: Topical pharmacologic treatments are the most common approach for managing extant AC; however, most available medications require multiple daily instillations. Dual-acting antihistamine-mast cell stabilizing agents are currently considered first-line therapeutics for AC because they provide acute relief of signs and symptoms and block persistent inflammation to promote regression of AC. Recent studies of a newly-developed, higher-concentration formulation of a dual-acting antihistamine-mast cell stabilizer have demonstrated that this formulation provides a 24-hour duration of action with once-daily dosing.

Conclusions: Dual-acting AC medications exhibit a high degree of overall effectiveness and are well tolerated for chronic use. A newly available once-daily medication that manages signs and symptoms of AC for a full 24 hours may be considered a treatment of choice for patients experiencing seasonal or perennial AC. ClinicalTrials.gov NCT01743027 and NCT01479374.

Figure 1.

Normal eye (left) and eye with inflammation caused by allergic conjunctivitis (right). The bulbar and palpebral conjunctiva are indicated.

Figure 2.

Mean treatment differences in ocular itching after conjunctival allergen challenge. Ocular itching was assessed at 3, 5, and 7 minutes. *p < 0.001, †p < 0.01, ‡p < 0.05. Reproduced with permission (from Ref. 52).

Figure 3.

Ocular itching examined after conjunctival allergen challenge. (A) Olopatadine 0.77% versus vehicle at onset and 24 hours after instillation. (B) Olopatadine 0.77% versus olopatadine 0.2% 24 hours after instillation. (C) Olopatadine 0.77% versus olopatadine 0.1% at 24 hours after instillation. *p < 0.0001 versus olopatadine 0.77%, †p < 0.05 versus olopatadine 0.77%. Ocular itching scores were assessed on a 0–4 scale with 0.5-unit increments (0, none; 4, incapacitating itch). Reproduced with permission (from Ref. 53).