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Review
. 2024 Sep 21:18:2657-2666.
doi: 10.2147/OPTH.S470657. eCollection 2024.

The Efficacy and Safety of Dexamethasone Intracanalicular Insert Use in Patients with Chronic Seasonal/Perennial Allergic Conjunctivitis: A Systematic Review and Meta-Analysis

Ali S Alsudais  1   2 , Waleed Mohammed Alshehri  3 , Ahmed M Alrehaili  4 , Reyadh Khalid Albeladi  5 , Mohammed Khoshhal  4   6 , Ahmed Albelowi  4 , Raghad Saleh Alzahrani  1   2 , Ahmed Alnabihi  1   2 , Bader Bashrahil  1   2 , Omar Alabbasi  3
Affiliations
Review

The Efficacy and Safety of Dexamethasone Intracanalicular Insert Use in Patients with Chronic Seasonal/Perennial Allergic Conjunctivitis: A Systematic Review and Meta-Analysis

Ali S Alsudais et al. Clin Ophthalmol. .

Abstract

Objective: This meta-analysis evaluated the efficacy and safety of DEXTENZA, an intracanalicular dexamethasone insert, for the treatment of seasonal/perennial allergic conjunctivitis.

Methods: Multiple databases, including PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, the Directory of Open Access Journals, and Scopus, were searched for randomized controlled trials (RCTs) comparing the efficacy of DEXTENZA with a placebo. The primary efficacy endpoint was the change in the conjunctival allergen challenge (CAC) model. The GRADE approach was used to assess the certainty of evidence, and the revised Cochrane risk of bias tool for randomized trials was employed to assess bias.

Results: Four RCTs involving 323 participants met the eligibility criteria, and all had a low risk of bias. A meta-analysis revealed a statistically significant increase in the mean CAC change for conjunctival itching, with low heterogeneity among measurements at 3 minutes (P < 0.00001, I2 = 47%), 5 minutes (P < 0.00001, I2 = 46%), and 7 minutes (P < 0.00001, I2 = 41%). Additionally, the meta-analysis found a statistically significant increase in the mean CAC change for conjunctival redness with low heterogeneity (P < 0.00001, I2 = 15%). The pooled analysis showed no significant difference (P = 0.57, I2 = 0%) between the DEXTENZA and placebo groups in the frequency of adverse events.

Conclusion: DEXTENZA has emerged as a promising and viable treatment option for patients with seasonal/perennial allergic conjunctivitis and is an effective alternative to current therapeutic modalities.

Keywords: DEXTENZA; allergic conjunctivitis; conjunctivitis; dexamethasone insert.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
PRISMA flowchart. *Cochrane Central Register of Controlled Trials **Directory of Open Access Journals.
Figure 2
Figure 2
Risk of bias graph.
Figure 3
Figure 3
Forest plot of ocular itching in the conjunctival allergen challenge (CAC) model.
Figure 4
Figure 4
Forest plot of conjunctival redness in the conjunctival allergen challenge (CAC) model.
See this image and copyright information in PMC

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