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Published in: Advances in Therapy 10/2014

Open Access 01-10-2014 | Original Research

Ocular Itch Relief with Alcaftadine 0.25% Versus Olopatadine 0.2% in Allergic Conjunctivitis: Pooled Analysis of Two Multicenter Randomized Clinical Trials

Authors: Eugene B. McLaurin, Nicholas P. Marsico, Stacey L. Ackerman, Joseph B. Ciolino, Julia M. Williams, Linda Villanueva, David A. Hollander

Published in: Advances in Therapy | Issue 10/2014

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Abstract

Introduction

The efficacy and safety of the once-daily topical ophthalmic solutions, alcaftadine 0.25% and olopatadine 0.2%, in preventing ocular itching associated with allergic conjunctivitis were evaluated.

Methods

Pooled analysis was conducted of two double-masked, multicenter, active- and placebo-controlled studies using the conjunctival allergen challenge (CAC) model of allergic conjunctivitis. Subjects were randomized 1:1:1 to receive alcaftadine 0.25%, olopatadine 0.2%, or placebo. The primary efficacy measure was subject-evaluated mean ocular itching at 3 min post-CAC and 16 h after treatment instillation. Secondary measures included ocular itching at 5 and 7 min post-CAC. Ocular itch was determined over all time points measured (3, 5, and 7 min) post-CAC and the proportion of subjects with minimal itch (itch score <1) and zero itch (itch score = 0) was also assessed.

Results

A total of 284 subjects were enrolled in the two studies. At 3 min post-CAC and 16 h after treatment instillation, alcaftadine 0.25% achieved a significantly lower mean itch score compared with olopatadine 0.2% (0.50 vs. 0.87, respectively; P = 0.0006). Alcaftadine demonstrated a significantly lower mean itch score over all time points compared with olopatadine (0.68 vs. 0.92, respectively; P = 0.0390); both alcaftadine- and olopatadine-treated subjects achieved significantly lower overall mean ocular itching scores compared with placebo (2.10; P < 0.0001 for both actives). Minimal itch over all time points was reported by 76.1% of alcaftadine-treated subjects compared with 58.1% of olopatadine-treated subjects (P = 0.0121). Treatment with alcaftadine 0.25% and olopatadine 0.2% was safe and well tolerated; no serious adverse events were reported.

Conclusion

Once-daily alcaftadine 0.25% ophthalmic solution demonstrated greater efficacy in prevention of ocular itching compared with olopatadine 0.2% at 3 min post-CAC (primary endpoint), and over all time points, 16 h post-treatment instillation. Alcaftadine and olopatadine both provided effective relief compared with placebo and were generally well tolerated.
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Literature
1.
go back to reference Mortemousque B, Fauquert JL, Chiambaretta F, Demoly P, Helleboid L, Creuzot-Garcher C, et al. Conjunctival provocation test: recommendations. J Fr Ophtalmol. 2006;29:837–46.PubMedCrossRef Mortemousque B, Fauquert JL, Chiambaretta F, Demoly P, Helleboid L, Creuzot-Garcher C, et al. Conjunctival provocation test: recommendations. J Fr Ophtalmol. 2006;29:837–46.PubMedCrossRef
2.
go back to reference Leonardi A, Bogacka E, Fauquert JL, Kowalski ML, Groblewska A, Jedrzejczak-Czechowicz M, et al. Ocular allergy: recognizing and diagnosing hypersensitivity disorders of the ocular surface. Allergy. 2012;67:1327–37.PubMedCrossRef Leonardi A, Bogacka E, Fauquert JL, Kowalski ML, Groblewska A, Jedrzejczak-Czechowicz M, et al. Ocular allergy: recognizing and diagnosing hypersensitivity disorders of the ocular surface. Allergy. 2012;67:1327–37.PubMedCrossRef
3.
go back to reference Rosario N, Bielory L. Epidemiology of allergic conjunctivitis. Curr Opin Allergy Clin Immunol. 2011;11:471–6.PubMedCrossRef Rosario N, Bielory L. Epidemiology of allergic conjunctivitis. Curr Opin Allergy Clin Immunol. 2011;11:471–6.PubMedCrossRef
4.
5.
go back to reference Singh K, Axelrod S, Bielory L. The epidemiology of ocular and nasal allergy in the United States, 1988–1994. J Allergy Clin Immunol. 2010;126:778–83.e6.CrossRef Singh K, Axelrod S, Bielory L. The epidemiology of ocular and nasal allergy in the United States, 1988–1994. J Allergy Clin Immunol. 2010;126:778–83.e6.CrossRef
6.
go back to reference Björksten B, Clayton T, Ellwood P, Stewart A, Strachan D, ISAAC Phase III Study Group. Worldwide time trends for symptoms of rhinitis and conjunctivitis: phase III of the International Study of Asthma and Allergies in Childhood. Pediatr Allergy Immunol. 2008;19:110–24.PubMedCrossRef Björksten B, Clayton T, Ellwood P, Stewart A, Strachan D, ISAAC Phase III Study Group. Worldwide time trends for symptoms of rhinitis and conjunctivitis: phase III of the International Study of Asthma and Allergies in Childhood. Pediatr Allergy Immunol. 2008;19:110–24.PubMedCrossRef
7.
go back to reference Collum L, Kilmartin DJ. Acute Allergic Conjunctivitis. In: Abelson MB, editor. Allergic diseases of the eye. Philadelphia: W.B. Saunders Co; 2000. p. 108–32. Collum L, Kilmartin DJ. Acute Allergic Conjunctivitis. In: Abelson MB, editor. Allergic diseases of the eye. Philadelphia: W.B. Saunders Co; 2000. p. 108–32.
8.
go back to reference Leonardi A, De Dominicis C, Motterle L. Immunopathogenesis of ocular allergy: a schematic approach to different clinical entities. Curr Opin Allergy Clin Immunol. 2007;7:429–35.PubMedCrossRef Leonardi A, De Dominicis C, Motterle L. Immunopathogenesis of ocular allergy: a schematic approach to different clinical entities. Curr Opin Allergy Clin Immunol. 2007;7:429–35.PubMedCrossRef
9.
go back to reference Ono SJ, Abelson MB. Allergic conjunctivitis: update on pathophysiology and prospects for future treatment. J Allergy Clin Immunol. 2005;115:118–22.PubMedCrossRef Ono SJ, Abelson MB. Allergic conjunctivitis: update on pathophysiology and prospects for future treatment. J Allergy Clin Immunol. 2005;115:118–22.PubMedCrossRef
10.
11.
go back to reference Bielory L, Ghafoor S. Histamine receptors and the conjunctiva. Curr Opin Allergy Clin Immunol. 2005;5:437–40.PubMedCrossRef Bielory L, Ghafoor S. Histamine receptors and the conjunctiva. Curr Opin Allergy Clin Immunol. 2005;5:437–40.PubMedCrossRef
12.
go back to reference Nakano Y, Takahashi Y, Ono R, Kurata Y, Kagawa Y, Kamei C. Role of histamine H4 receptor in allergic conjunctivitis in mice. Eur J Pharmacol. 2009;608:71–5.PubMedCrossRef Nakano Y, Takahashi Y, Ono R, Kurata Y, Kagawa Y, Kamei C. Role of histamine H4 receptor in allergic conjunctivitis in mice. Eur J Pharmacol. 2009;608:71–5.PubMedCrossRef
13.
go back to reference Zampeli E, Thurmond RL, Tiligada E. The histamine H4 receptor antagonist JNJ7777120 induces increases in the histamine content of the rat conjunctiva. Inflamm Res. 2009;58:285–91.PubMedCrossRef Zampeli E, Thurmond RL, Tiligada E. The histamine H4 receptor antagonist JNJ7777120 induces increases in the histamine content of the rat conjunctiva. Inflamm Res. 2009;58:285–91.PubMedCrossRef
14.
go back to reference Greiner JV, Edwards-Swanson K, Ingerman A. Evaluation of alcaftadine 0.25% ophthalmic solution in acute allergic conjunctivitis at 15 minutes and 16 hours after instillation versus placebo and olopatadine 0.1%. Clin Ophthalmol. 2011;5:87–93.PubMedPubMedCentral Greiner JV, Edwards-Swanson K, Ingerman A. Evaluation of alcaftadine 0.25% ophthalmic solution in acute allergic conjunctivitis at 15 minutes and 16 hours after instillation versus placebo and olopatadine 0.1%. Clin Ophthalmol. 2011;5:87–93.PubMedPubMedCentral
15.
go back to reference Torkildsen G, Shedden A. The safety and efficacy of alcaftadine 0.25% ophthalmic solution for the prevention of itching associated with allergic conjunctivitis. Curr Med Res Opin. 2011;27:623–31.PubMedCrossRef Torkildsen G, Shedden A. The safety and efficacy of alcaftadine 0.25% ophthalmic solution for the prevention of itching associated with allergic conjunctivitis. Curr Med Res Opin. 2011;27:623–31.PubMedCrossRef
17.
go back to reference Abelson MB, Spangler DL, Epstein AB, Mah FS, Crampton HJ. Efficacy of once-daily olopatadine 0.2% ophthalmic solution compared to twice-daily olopatadine 0.1% ophthalmic solution for the treatment of ocular itching induced by conjunctival allergen challenge. Curr Eye Res. 2007;32:1017–22.PubMedCrossRef Abelson MB, Spangler DL, Epstein AB, Mah FS, Crampton HJ. Efficacy of once-daily olopatadine 0.2% ophthalmic solution compared to twice-daily olopatadine 0.1% ophthalmic solution for the treatment of ocular itching induced by conjunctival allergen challenge. Curr Eye Res. 2007;32:1017–22.PubMedCrossRef
18.
go back to reference Scoper SV, Berdy GJ, Lichtenstein SJ, Rubin JM, Bloomenstein M, Prouty RE, et al. Perception and quality of life associated with the use of olopatadine 0.2% (Pataday) in patients with active allergic conjunctivitis. Adv Ther. 2007;24:1221–32.PubMedCrossRef Scoper SV, Berdy GJ, Lichtenstein SJ, Rubin JM, Bloomenstein M, Prouty RE, et al. Perception and quality of life associated with the use of olopatadine 0.2% (Pataday) in patients with active allergic conjunctivitis. Adv Ther. 2007;24:1221–32.PubMedCrossRef
20.
go back to reference Wade L, Bielory L, Rudner S. Ophthalmic antihistamines and H1–H4 receptors. Curr Opin Allergy Clin Immunol. 2012;12:510–6.PubMedCrossRef Wade L, Bielory L, Rudner S. Ophthalmic antihistamines and H1–H4 receptors. Curr Opin Allergy Clin Immunol. 2012;12:510–6.PubMedCrossRef
21.
go back to reference Abelson MB, Chambers WA, Smith LM. Conjunctival allergen challenge. A clinical approach to studying allergic conjunctivitis. Arch Ophthalmol. 1990;108:84–8.PubMedCrossRef Abelson MB, Chambers WA, Smith LM. Conjunctival allergen challenge. A clinical approach to studying allergic conjunctivitis. Arch Ophthalmol. 1990;108:84–8.PubMedCrossRef
22.
go back to reference Abelson MB, Loeffler O. Conjunctival allergen challenge: models in the investigation of ocular allergy. Curr Allergy Asthma Rep. 2003;3:363–8.PubMedCrossRef Abelson MB, Loeffler O. Conjunctival allergen challenge: models in the investigation of ocular allergy. Curr Allergy Asthma Rep. 2003;3:363–8.PubMedCrossRef
23.
go back to reference Abelson MB. Evaluation of olopatadine, a new ophthalmic antiallergic agent with dual activity, using the conjunctival allergen challenge model. Ann Allergy Asthma Immunol. 1998;81:211–8.PubMedCrossRef Abelson MB. Evaluation of olopatadine, a new ophthalmic antiallergic agent with dual activity, using the conjunctival allergen challenge model. Ann Allergy Asthma Immunol. 1998;81:211–8.PubMedCrossRef
24.
go back to reference Abelson MB, Gomes P, Crampton HJ, Schiffman RM, Bradford RR, Whitcup SM. Efficacy and tolerability of ophthalmic epinastine assessed using the conjunctival antigen challenge model in patients with a history of allergic conjunctivitis. Clin Ther. 2004;26:35–47.PubMedCrossRef Abelson MB, Gomes P, Crampton HJ, Schiffman RM, Bradford RR, Whitcup SM. Efficacy and tolerability of ophthalmic epinastine assessed using the conjunctival antigen challenge model in patients with a history of allergic conjunctivitis. Clin Ther. 2004;26:35–47.PubMedCrossRef
25.
go back to reference Abelson MB, Torkildsen GL, Williams JI, Gow JA, Gomes PJ. McNamara TR; Bepotastine Besilate Ophthalmic Solutions Clinical Study Group. Time to onset and duration of action of the antihistamine bepotastine besilate ophthalmic solutions 1.0% and 1.5% in allergic conjunctivitis: a phase III, single-center, prospective, randomized, double-masked, placebo-controlled, conjunctival allergen challenge assessment in adults and children. Clin Ther. 2009;31:1908–21.PubMedCrossRef Abelson MB, Torkildsen GL, Williams JI, Gow JA, Gomes PJ. McNamara TR; Bepotastine Besilate Ophthalmic Solutions Clinical Study Group. Time to onset and duration of action of the antihistamine bepotastine besilate ophthalmic solutions 1.0% and 1.5% in allergic conjunctivitis: a phase III, single-center, prospective, randomized, double-masked, placebo-controlled, conjunctival allergen challenge assessment in adults and children. Clin Ther. 2009;31:1908–21.PubMedCrossRef
26.
go back to reference Ackerman S, D’Ambrosio F Jr., Greiner JV, Villanueva L, Ciolino JB, Hollander DA. A multicenter evaluation of the efficacy and duration of action of alcaftadine 0.25% and olopatadine 0.2% in the conjunctival allergen challenge model. J Asthma Allergy. 2013;6:43–52.PubMedCrossRefPubMedCentral Ackerman S, D’Ambrosio F Jr., Greiner JV, Villanueva L, Ciolino JB, Hollander DA. A multicenter evaluation of the efficacy and duration of action of alcaftadine 0.25% and olopatadine 0.2% in the conjunctival allergen challenge model. J Asthma Allergy. 2013;6:43–52.PubMedCrossRefPubMedCentral
27.
go back to reference McLaurin EB, Marsico NP, Ciolino JB, Williams JM, Hollander DA. Alcaftadine 0.25% versus olopatadine 0.2% in the prevention of ocular itching in allergic conjunctivitis. Presented at: American College of Allergy, Asthma and Immunology 2013 Annual Scientific Meeting; November 7–11, 2013; Baltimore, MD. McLaurin EB, Marsico NP, Ciolino JB, Williams JM, Hollander DA. Alcaftadine 0.25% versus olopatadine 0.2% in the prevention of ocular itching in allergic conjunctivitis. Presented at: American College of Allergy, Asthma and Immunology 2013 Annual Scientific Meeting; November 7–11, 2013; Baltimore, MD.
28.
go back to reference McLaurin EB, Marsico NP, Ciolino JB, Williams JM, Hollander DA. Alcaftadine 0.25% versus olopatadine 0.2% in prevention of ocular itching due to allergic conjunctivitis in a CAC™ model. Presented at: American Academy of Ophthalmology 2013 Annual Meeting; November 16–19, 2013; New Orleans, LA. McLaurin EB, Marsico NP, Ciolino JB, Williams JM, Hollander DA. Alcaftadine 0.25% versus olopatadine 0.2% in prevention of ocular itching due to allergic conjunctivitis in a CAC™ model. Presented at: American Academy of Ophthalmology 2013 Annual Meeting; November 16–19, 2013; New Orleans, LA.
30.
go back to reference Namdar R, Valdez C. Alcaftadine: a topical antihistamine for use in allergic conjunctivitis. Drugs Today (Barc). 2011;47:883–90.PubMedCrossRef Namdar R, Valdez C. Alcaftadine: a topical antihistamine for use in allergic conjunctivitis. Drugs Today (Barc). 2011;47:883–90.PubMedCrossRef
31.
go back to reference Ling P, Ngo K, Nguyen S, Thurmond RL, Edwards JP, Karlsson L, et al. Histamine H4 receptor mediates eosinophil chemotaxis with cell shape change and adhesion molecule upregulation. Br J Pharmacol. 2004;142:161–71.PubMedCrossRefPubMedCentral Ling P, Ngo K, Nguyen S, Thurmond RL, Edwards JP, Karlsson L, et al. Histamine H4 receptor mediates eosinophil chemotaxis with cell shape change and adhesion molecule upregulation. Br J Pharmacol. 2004;142:161–71.PubMedCrossRefPubMedCentral
32.
go back to reference Ono SJ, Lane K. Comparison of effects of alcaftadine and olopatadine on conjunctival epithelium and eosinophil recruitment in a murine model of allergic conjunctivitis. Drug Des Devel Ther. 2011;5:77–84.PubMedPubMedCentral Ono SJ, Lane K. Comparison of effects of alcaftadine and olopatadine on conjunctival epithelium and eosinophil recruitment in a murine model of allergic conjunctivitis. Drug Des Devel Ther. 2011;5:77–84.PubMedPubMedCentral
33.
go back to reference Contreras-Ruiz L, Schulze U, García-Posadas L, Arranz-Valsero I, Lopez-Garcia A, Paulsen F, et al. Structural and functional alteration of corneal epithelial barrier under inflammatory conditions. Curr Eye Res. 2012;37:971–81.PubMedCrossRef Contreras-Ruiz L, Schulze U, García-Posadas L, Arranz-Valsero I, Lopez-Garcia A, Paulsen F, et al. Structural and functional alteration of corneal epithelial barrier under inflammatory conditions. Curr Eye Res. 2012;37:971–81.PubMedCrossRef
Metadata
Title
Ocular Itch Relief with Alcaftadine 0.25% Versus Olopatadine 0.2% in Allergic Conjunctivitis: Pooled Analysis of Two Multicenter Randomized Clinical Trials
Authors
Eugene B. McLaurin
Nicholas P. Marsico
Stacey L. Ackerman
Joseph B. Ciolino
Julia M. Williams
Linda Villanueva
David A. Hollander
Publication date
01-10-2014
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 10/2014
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-014-0155-3

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