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Published in: Journal of Ophthalmic Inflammation and Infection 4/2011

Open Access 01-12-2011 | Original Research

Phase II placebo-controlled study of nepafenac ophthalmic suspension 0.1% for postoperative inflammation and ocular pain associated with cataract surgery in Japanese patients

Author: Jiro Numaga

Published in: Journal of Ophthalmic Inflammation and Infection | Issue 4/2011

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Abstract

Objective

This study aimed to examine the efficacy and safety of nepafenac ophthalmic suspension compared to placebo in the management of postoperative inflammation and ocular pain in Japanese patients undergoing cataract surgery.

Methods

This was a multicenter, randomized, double-masked, placebo-controlled clinical study. Patients received nepafenac or placebo TID beginning 1 day before cataract surgery and continuing on the day of surgery for 14 days. One additional drop was administered on the day of surgery. The primary efficacy variables were the percentage of patients cured at postoperative day 14 visit (cure defined as aqueous cells score + aqueous flare score = 0) and the percentage of patients who were pain free at all postoperative visits.

Results

The cure rate on day 14 after surgery was 71.4% (75/105) in the nepafenac group and 28.6% (30/105) in the placebo group, showing a significant difference in cure rate between groups. The nepafenac group demonstrated higher cure rates than those in the placebo group, with a significant difference in cure rate on days 7 and 14 postoperatively. The ocular pain-free rate was 96.2% (102/106) in the nepafenac group and 67.6% (71/105) in the placebo group, showing a significant difference between groups. Concerning adverse events (AEs), 26 AEs were reported in 21 subjects (19.6%) in the nepafenac group and 31 AEs were reported in 24 subjects (22.4%) in the placebo group.

Conclusion

Nepafenac ophthalmic suspension is a nonsteroidal anti-inflammatory drug effective in the prevention of postoperative inflammation and ocular pain associated with cataract surgery.
Literature
1.
go back to reference Walters T, Raizman M, Ernest P, Gayton J, Lehmann R (2007) In vivo pharmacokinetics and in vitro pharmacodynamics of nepafenac, amfenac, ketorolac, and bromfenac. J Cataract Refract Surg 33:1539–1545PubMedCrossRef Walters T, Raizman M, Ernest P, Gayton J, Lehmann R (2007) In vivo pharmacokinetics and in vitro pharmacodynamics of nepafenac, amfenac, ketorolac, and bromfenac. J Cataract Refract Surg 33:1539–1545PubMedCrossRef
2.
go back to reference Gamache DA, Graff G, Brady MT, Spellman JM, Yanni JM (2000) Nepafenac, a unique nonsteroidal prodrug with potential utility in the treatment of trauma-induced ocular inflammation: I. Assessment of anti-inflammatory efficacy. Inflammation 24:357–370PubMedCrossRef Gamache DA, Graff G, Brady MT, Spellman JM, Yanni JM (2000) Nepafenac, a unique nonsteroidal prodrug with potential utility in the treatment of trauma-induced ocular inflammation: I. Assessment of anti-inflammatory efficacy. Inflammation 24:357–370PubMedCrossRef
3.
go back to reference Emery JM, Little JH (1979) Phacoemulsification and aspiration of cataract: surgical techniques, complications, and results. Mosby, St Louis, pp 45–48 Emery JM, Little JH (1979) Phacoemulsification and aspiration of cataract: surgical techniques, complications, and results. Mosby, St Louis, pp 45–48
4.
go back to reference Lane SS, Modi SS, Lehmann RP, Holland EJ (2007) Nepafenac ophthalmic suspension 0.1% for the prevention and treatment of ocular inflammation associated with cataract surgery. J Cataract Refract Surgery 33:53–58CrossRef Lane SS, Modi SS, Lehmann RP, Holland EJ (2007) Nepafenac ophthalmic suspension 0.1% for the prevention and treatment of ocular inflammation associated with cataract surgery. J Cataract Refract Surgery 33:53–58CrossRef
5.
go back to reference Nardi M, Lobo C, Bereczki A, Cano J, Zagato E, Potts S, Sullins G, Notivol R, for the International C-04–65 Study Group (2007) Analgesic and anti-inflammatory effectiveness of nepafenac 0.1% for cataract surgery. Clin Ophthalmol 1:527–533PubMedPubMedCentral Nardi M, Lobo C, Bereczki A, Cano J, Zagato E, Potts S, Sullins G, Notivol R, for the International C-04–65 Study Group (2007) Analgesic and anti-inflammatory effectiveness of nepafenac 0.1% for cataract surgery. Clin Ophthalmol 1:527–533PubMedPubMedCentral
6.
go back to reference Maxwell WA, Reiser HJ, Stewart RH, Cavanagh HD, Walters TR, Sager DP, Meuse PA, the Nepafenac Study Group (2008) Nepafenac dosing frequency for ocular pain and inflammation associated with cataract surgery. J Ocul Pharmacol Ther 24:593–599PubMedCrossRef Maxwell WA, Reiser HJ, Stewart RH, Cavanagh HD, Walters TR, Sager DP, Meuse PA, the Nepafenac Study Group (2008) Nepafenac dosing frequency for ocular pain and inflammation associated with cataract surgery. J Ocul Pharmacol Ther 24:593–599PubMedCrossRef
7.
go back to reference Reddy MS, Suneetha N, Thomas RK, Battu RR (2000) Topical diclofenac sodium for treatment of postoperative inflammation in cataract surgery. Indian J Ophthalmol 48:223–226PubMed Reddy MS, Suneetha N, Thomas RK, Battu RR (2000) Topical diclofenac sodium for treatment of postoperative inflammation in cataract surgery. Indian J Ophthalmol 48:223–226PubMed
8.
go back to reference el-Harazi SM, Ruiz RS, Feldman RM, Villanueva G, Chuang AZ (1998) A randomized double-masked trial comparing ketorolac tromethamine 0.5%, diclofenac sodium 0.1%, and prednisolone acetate 1% in reducing post-phacoemulsification flare and cells. Ophthalmic Surg Lasers 29:539–544PubMed el-Harazi SM, Ruiz RS, Feldman RM, Villanueva G, Chuang AZ (1998) A randomized double-masked trial comparing ketorolac tromethamine 0.5%, diclofenac sodium 0.1%, and prednisolone acetate 1% in reducing post-phacoemulsification flare and cells. Ophthalmic Surg Lasers 29:539–544PubMed
9.
go back to reference Demco TA, Sutton H, Demco CJ, Raj PS (1997) Topical diclofenac sodium compared with prednisolone acetate after phacoemulsification-lens implant surgery. Eur J Ophthalmol 7:236–240PubMed Demco TA, Sutton H, Demco CJ, Raj PS (1997) Topical diclofenac sodium compared with prednisolone acetate after phacoemulsification-lens implant surgery. Eur J Ophthalmol 7:236–240PubMed
10.
go back to reference Donnenfeld ED, Holland EJ, Sewart RH, Gow JA, Grillone LR, Bromfenac Ophthalmic Solution 0.09%(Xibrom) Study group (2007) Bromfenac ophthalmic solution 0.09%(Xibrom) for postoperative ocular pain and inflammation. Ophthalmology 114:1653–1662PubMedCrossRef Donnenfeld ED, Holland EJ, Sewart RH, Gow JA, Grillone LR, Bromfenac Ophthalmic Solution 0.09%(Xibrom) Study group (2007) Bromfenac ophthalmic solution 0.09%(Xibrom) for postoperative ocular pain and inflammation. Ophthalmology 114:1653–1662PubMedCrossRef
11.
go back to reference Herbort CP, Jauch A, Othenin-Girard P, Tritten JJ, Fsadni M (2000) Diclofenac drops to treat inflammation after cataract surgery. Acta Ophthalmol Scand 78:421–424PubMedCrossRef Herbort CP, Jauch A, Othenin-Girard P, Tritten JJ, Fsadni M (2000) Diclofenac drops to treat inflammation after cataract surgery. Acta Ophthalmol Scand 78:421–424PubMedCrossRef
12.
go back to reference Othenin-Girard P, Tritten JJ, Pittet N, Herbort CP (1994) Dexamethasone versus diclofenac sodium eyedrops to treat inflammation after cataract surgery. J Cataract Refract Surg 20:9–12PubMedCrossRef Othenin-Girard P, Tritten JJ, Pittet N, Herbort CP (1994) Dexamethasone versus diclofenac sodium eyedrops to treat inflammation after cataract surgery. J Cataract Refract Surg 20:9–12PubMedCrossRef
13.
go back to reference Miyake K, Sakamura S, Miura H (1980) Long-term follow up study on the prevention of aphakic cystoid macular edema by topical indomethacin. Br J Ophthalmol 64:324–328PubMedPubMedCentralCrossRef Miyake K, Sakamura S, Miura H (1980) Long-term follow up study on the prevention of aphakic cystoid macular edema by topical indomethacin. Br J Ophthalmol 64:324–328PubMedPubMedCentralCrossRef
14.
go back to reference Rossetti L, Bujtar E, Castoldi D, Torrazza C, Orzalesi N (1996) Effectiveness of diclofenac eyedrops in reducing inflammation and the incidence of cystoid macular edema after cataract surgery. J Cataract Refract Surg 22(Suppl 1):794–799PubMedCrossRef Rossetti L, Bujtar E, Castoldi D, Torrazza C, Orzalesi N (1996) Effectiveness of diclofenac eyedrops in reducing inflammation and the incidence of cystoid macular edema after cataract surgery. J Cataract Refract Surg 22(Suppl 1):794–799PubMedCrossRef
15.
go back to reference Flach AJ, Stegman RC, Graham J, Kruger LP (1990) Prophylaxis of aphakic cystoid macular edema without corticosteroids, a paired-comparison, placebo-controlled double-masked study. Ophthalmology 97:1253–1258PubMedCrossRef Flach AJ, Stegman RC, Graham J, Kruger LP (1990) Prophylaxis of aphakic cystoid macular edema without corticosteroids, a paired-comparison, placebo-controlled double-masked study. Ophthalmology 97:1253–1258PubMedCrossRef
16.
go back to reference Miyake K, Masuda K, Shirato S, Oshika T, Eguchi K, Hoshi H, Majima Y, Kimura W, Hayashi F (2000) Comparison of diclofenac and fluorometholone in preventing cystoid macular edema after small incision cataract surgery: a multicentered prospective trial. Jpn J Ophthalmol 44:58–67PubMedCrossRef Miyake K, Masuda K, Shirato S, Oshika T, Eguchi K, Hoshi H, Majima Y, Kimura W, Hayashi F (2000) Comparison of diclofenac and fluorometholone in preventing cystoid macular edema after small incision cataract surgery: a multicentered prospective trial. Jpn J Ophthalmol 44:58–67PubMedCrossRef
17.
go back to reference Ke T-L, Graff G, Spellman JM, Yanni JM (2000) Nepafenac, a unique nonsteroidal prodrug with potential utility in the treatment of trauma-induced ocular inflammation: II. In vitro bioactivation and permeation of external ocular barriers. Inflammation 24:371–384PubMedCrossRef Ke T-L, Graff G, Spellman JM, Yanni JM (2000) Nepafenac, a unique nonsteroidal prodrug with potential utility in the treatment of trauma-induced ocular inflammation: II. In vitro bioactivation and permeation of external ocular barriers. Inflammation 24:371–384PubMedCrossRef
18.
go back to reference Sawa M, Tsurimaki Y, Tsuru T, Shimizu H (1988) New quantitative method to determine protein concentration and cell numbr in aqueous in vivo. Jpn J Ophthalmol 32:132–142PubMed Sawa M, Tsurimaki Y, Tsuru T, Shimizu H (1988) New quantitative method to determine protein concentration and cell numbr in aqueous in vivo. Jpn J Ophthalmol 32:132–142PubMed
19.
go back to reference Oshika T, Yoshimura K, Miyata N (1992) Postsurgical inflammation after phacoemulsification and extracapsular ectraction with soft or conventional intraocular lens implantaion. J Cataract Refract Surg 18:356–361PubMedCrossRef Oshika T, Yoshimura K, Miyata N (1992) Postsurgical inflammation after phacoemulsification and extracapsular ectraction with soft or conventional intraocular lens implantaion. J Cataract Refract Surg 18:356–361PubMedCrossRef
21.
go back to reference Guidera AC, Luchs JI, Udell IJ (2001) Keratitis, ulceration, and perforation associated with topical nonsteroidal anti-inflammatory drugs. Ophthalmology 108:936–944PubMedCrossRef Guidera AC, Luchs JI, Udell IJ (2001) Keratitis, ulceration, and perforation associated with topical nonsteroidal anti-inflammatory drugs. Ophthalmology 108:936–944PubMedCrossRef
Metadata
Title
Phase II placebo-controlled study of nepafenac ophthalmic suspension 0.1% for postoperative inflammation and ocular pain associated with cataract surgery in Japanese patients
Author
Jiro Numaga
Publication date
01-12-2011
Publisher
Springer Berlin Heidelberg
Published in
Journal of Ophthalmic Inflammation and Infection / Issue 4/2011
Electronic ISSN: 1869-5760
DOI
https://doi.org/10.1007/s12348-011-0036-8

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